In an effort to continue assessing the pandemic’s impact on Virginia’s hospitals, the Virginia Hospital and Healthcare Association (VHHA) provided a data briefing on the latest hospitalization and emergency department (ED) trends. This month’s briefing is the agency’s third, following one in Oct. 2020 and another in April 2021.
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VHHA collected information from 91 hospitals in its inpatient database, as well as submissions from 81 hospitals in its voluntary ED database. The data briefing included information on the impact of COVID-19 on member hospital and ED volumes, length of stays, and discharges. The data also tracked hospitalization demographics, including age, ethnicity, and insurance type.
Virginia saw over 56,000 total COVID-19 hospitalizations, a majority of which occurred during the first surge last winter. Much of the data recorded hospital discharges, which the pandemic significantly affected. According to VHHA data, hospital discharges dropped as much as 31% in March and April 2020, as Gov. Ralph Northam issued a stay-at-home order and postponed elective surgeries for approximately five weeks.
David Vaamonde, VHHA vice president of data and analytics, pointed out that the pandemic lockdown impacted inpatient services in different ways. Hospitals group certain hospitalization diagnoses together into major diagnostic categories (MDC). In VHHA hospitals, most MDCs, such as blood and immunologic disease, digestive system disease, and nervous system disease, saw an increase in discharges at the beginning of the pandemic and have yet to recover to pre-COVID levels. Only two of 25 MDCs — burns and eye diseases — were not impacted by the pandemic.
One area of concern, Vaamonde said, is the increase in behavioral health and substance use-related discharges since the second quarter of 2021. As of Nov. 2021, average weekly discharges for this MDC were between 300-350, which is higher than previous years, including during the start of the pandemic.
The discharges raise questions about people deferring behavioral health care, as well as how the state is working to improve its community-based crisis response services to further reduce ED utilization for behavioral health issues.
Lisa Daily, executive director of the Treatment Advocacy Center, said one potential solution to address this issue includes amending state budget language to implement mandatory outpatient treatment (MOT) for people in recovery from behavioral health or substance use disorders.