Effects of COVID-19 on Hospital Utilization Trends

With the onset of COVID-19, hospitals statewide saw a sharp drop in inpatient discharges, emergency department utilization, and ambulatory surgeries.

Beginning in January 2020, hospitals throughout California began to see utilization drop sharply across all three settings. The downward trend continued until April 2020, after which utilization began to rise again. This drop is reflected when focusing on patients with common health conditions, such as diabetes, hypertension, and asthma. However, the homeless population did not show similar downward trends in utilization compared to other groups.

Key Findings:#

  • Individuals with asthma, cancer, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, obesity, sepsis, and stroke all reflected a sharp decline in utilization across settings from January – April 2020.
  • The homeless population trendlines do not reflect the same change, aside from a decline in ambulatory surgeries in early 2020. Trendlines for homeless may not reflect actuality due to variations in reporting over time. The homeless population is undercounted in 2018 due to the inability to designate homeless persons by ZIP code that year. 
  • As COVID-19 patient deaths rose in 2020, mortality trends in populations with chronic conditions were largely unaffected, with a few exceptions. Fewer deaths occurred among cancer patients during hospital admission through the periods with data available. Deaths among asthma, sepsis, and homeless patients in the emergency department trended higher in 2020 through the periods with data available than in previous years.

The visualization below focuses on statewide utilization trends in inpatient discharges, emergency department utilization, and ambulatory surgeries beginning in 2018. The sharp downward trend in all three settings begins after January 2020 with the introduction of COVID-19, and hits a low point in April 2020 before beginning to rise again.

Note: Data is preliminary as of May 2021.

This visualization displays utilization trends in the same settings as above but focuses on trends among individuals with common health conditions. A sharp decline in utilization is seen from January – April 2020 among nearly all patients with common health conditions. Hospital utilization of the homeless population was much less affected. These trends reflect encounters and not unique patients. 

Note: Data is preliminary as of May 2021. The number of encounters is all recorded health care encounters for a specific health category. Individual patients may be counted in more than one category if they were diagnosed with multiple types of health categories during a single encounter (e.g., a person who was homeless and had diabetes would be counted in both homeless and diabetes categories).

This visualization focuses on mortality trends in inpatient discharges, emergency department utilization, and ambulatory surgeries beginning in 2018. As deaths in COVID-19 patients rose in 2020, mortality trends in populations with chronic conditions were largely unaffected through the periods with data available, with a few exceptions. Fewer deaths occurred among cancer patients during hospital admission through the periods with data available. Deaths among asthma, sepsis, and homeless patients in the emergency department trended higher in 2020 through the periods with data available than in previous years.

Note: Data is preliminary as of May 2021. The number of encounters is all recorded health care encounters for a specific health category. Individual patients may be counted in more than one category if they were diagnosed with multiple types of health categories during a single encounter (e.g., a person who was homeless and had diabetes would be counted in both homeless and diabetes categories).

For questions on this data, please contact us at DataAndReports@oshpd.ca.gov.

Additional Information#

Topic: Healthcare UtilizationPatient-Level Administrative
Temporal Coverage: 2018-2020
Spatial/Geographic Coverage: Statewide
Frequency: Quarterly
Source Link: Healthcare Utilization
Citation: Office of Statewide Health Planning and Development: Healthcare Utilization, Patient-Level Administrative