Impact of COVID-19 on Chronic Ambulatory-Care-Sensitive Condition Emergency Department Use Among Older Adults

J Am Board Fam Med. 2024 Aug 30:jabfm.2023.230386R1. doi: 10.3122/jabfm.2023.230386R1. Online ahead of print.

Abstract

Background: The COVID-19 pandemic social distancing requirements encouraged patients to avoid public spaces including in-office health care visits. Ambulatory-care-sensitive conditions (ACSCs) represent conditions that can be managed with quality primary care and when access is limited, these conditions can lead to avoidable emergency department (ED) visits.

Methods: Using national data on ED visits from 2019 to 2021 in the National Hospital Ambulatory Care Survey, we examined the impact of COVID-19 pandemic on ACSC ED visits among older adults (aged ≥65).

Results: The proportion of ED visits among older adults that were for ACSCs increased between 2019 (17.4%) and 2021 (18.5%). The trend in both rural (26.4%-28.6%) and urban areas (15.4%-16.8%) shows a significant jump from 2019 to 2021 (P < .001).

Conclusions: This rise in ACSC ED use is consistent with a delay in normal primary care during the pandemic.

Keywords: Access to Care; Ambulatory Care Sensitive Conditions; COVID-19; Emergency Departments; Pandemics; Primary Health Care.