Coronavirus: Hospital visits drop 65 percent since March

A nurse at the Dayton Children’s Hospital screens a young visitor for COVID-19 before he’s allowed to enter the facility on a recent afternoon. Dayton Children’s and other hospitals in the region require that anyone who enters their facilities be screened for the virus. CONTRIBUTED

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A nurse at the Dayton Children’s Hospital screens a young visitor for COVID-19 before he’s allowed to enter the facility on a recent afternoon. Dayton Children’s and other hospitals in the region require that anyone who enters their facilities be screened for the virus. CONTRIBUTED

Dayton area hospital visits have declined by a combined 65% since the stay-at-home order went into effect in mid-March and elective medical procedures were halted.

There were also a decline of major procedures to treat conditions such as acute coronary syndromes — including heart attacks — strokes, aortic aneurysm and dissection, said Sarah Hackenbracht, president and CEO of the Greater Dayton Area Hospital Association.

That could indicate some people put off seeking treatment for serious conditions, possibly for fear of being exposed to coronavirus.

“It is clear that these are not the types of medical events for which care at a hospital should be postponed,” Hackenbracht said.

Hospitals are considered essential, but doctors were prohibited from performing elective surgeries and procedures. On May 1 elective surgeries not requiring an overnight stay were once again permitted.
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In all, in-patient encounters dipped by 30% from the same period a year ago and outpatient procedures declined by 35%, according to GDAHA.

Returning to traditional patient volumes could take months, but the hospitals and their staffs are resilient, Hackenbracht said, noting that she’s confident they will rebound.

“Hospitals are very much prepared and ready to care for the community’s full compendium of health-care needs,” she said. “As our economy reopens, the Dayton region will need our hospitals to be able to perform their full scope of services — emergency, inpatient, outpatient and elective procedures — to care for our community.”

It’s not clear at this time how much revenue the region’s hospitals lost as a result of the reduction in visits the past couple of months, but those figures will be tallied at a later time, officials said.

However, the COVID-19 pandemic is expected to have an estimated $202.6 billion impact on the nation’s hospitals between March 1 and June 30, according to the American Hospital Association. That’s an average of more than $50 million in losses per month, the AHA said, adding that hospitals expect to keep losing money beyond June 30.

The region’s hospitals have worked to provide the best care to patients for decades, Hackenbracht said, and they’ve continued to do so during the COVID-19 pandemic and set aside competition for patients.

“Our hospitals have really put any differences aside to plan and prepare for that potential outbreak, or a potential surge and capacity related to the COVID-19,” she said. “It has been truly, truly impressive.”

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There’s no way to determine how many people who needed medical care did not visit area hospitals because of a fear of getting infected with the coronavirus. But under the leadership of GDAHA, infection control and clinical experts at each hospital have been meeting regularly to ensure they use best practices to minimize the chances of infections or diseases from spreading, said Brenda Kuhn, chief clinical officer for Kettering Health Network.

The pandemic has created a new normal, and as they adjust, area hospitals will change the way they provide care to patients, operate as a staff and use technology. Patients’ experiences will be different for the foreseeable future as hospitals adopt new policies in an effort to protect visitors and staff, officials said.

Although there will be a few differences in how individual hospitals operate, they’ve worked together through GDAHA to ensure their safety procedures and the way they go about protecting patients will be similar.

All hospitals have put markers on their floors throughout their facilities to ensure that people remain 6 feet apart as they practice social distancing. Face shields have been installed at registration areas. Waiting room seating has been adjusted to prevent people from sitting next to each other.

At Dayton Children’s Hospital, there are five steps to keeping patients and staff safe, said Kathy Zegarski, director of quality assurance and infection prevention. Everyone, including employees, who enters the hospital will be screened. They’ll be asked a series of questions to determine if they have coronavirus symptoms.

Next, their temperatures will be taken, and each visitor and patient will be given a wristband and mask. They’ll be taught how to put on the mask and they will have to sanitize their hands before entering the facility for their appointments or visit.

After each patient visit, the exam rooms and all the equipment will be disinfected. The waiting rooms and furniture will also be disinfected regularly, Zegarski said, noting that there will be a limited number of people allowed in the hospital at a time.

The hospital staff is required to wear masks and other personal protective equipment to ensure that they keep themselves safe but also to avoid infecting patients, she said.

“We want people to know that we are a safe place,” Zegarski said. “We recognize that we’re going to have patients who have coronavirus, and we have locations set up where we can take those patients who are sick and need to be admitted, and make sure that they get the appropriate care they need.”

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Premier Health is taking its safety practices to the next level, as the COVID-19 pandemic has given the company the opportunity to pivot and accelerate a number of its plans, said Stacey Lawson, a human resources vice president.

In addition to having employees wear masks, Premier will continue to encourage and support social distancing throughout its facilities. Certain staffers who don’t see patients on regularly will continue working from home, and there will be even more virtual meetings as part of their efforts to limit the number of people in their hospitals.

Although they’ve been using telehealth — which allow doctors to examine patients virtually — since the pandemic started, there will be much greater use of the technology moving forward, she said.

“Obviously, we’re finding new work flows to minimize the amount of time that patients have to spend in waiting areas,” Lawson said. “But I would also say we are looking at new work flows for how we communicate. We’re looking at new work flows for how we get the work done, we’re looking at new work flows for even having meetings.”

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Kettering Health hospitals will also ramp up outpatient services and surgeries as the governor lifts more restrictions, Kuhn said. They will continued to follow the state’s orders in various areas, including visitor restrictions, and make changes when necessary.

“We have a motto, ‘A great place to work is a safe place to work,’ and patient safety is always at the forefront of the work that we do, and that is as a (hospital) community,” she said. “So we have our baseline standards for the care that we provide. And then we go forward, just to provide extra safety.”

Decline in area hospital procedures compared to 2019:

  • 31% decline for atrial fibrillation (AFib) hospitalizations
  • 32% decline for transient ischemic attacks and related syndromes ("mini strokes")
  • 16% decline for epilepsy and seizures
  • 18% decline for gastrointestinal bleeding
  • 11% decline for acute appendicitis
  • 49% decline for acute coronary syndromes, including heart attacks

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