For a study, researchers sought to determine if a COVID-19-related state-wide lockout was more likely to result in a potentially avoidable transfer (PAT).
After “Safer at Home” directives were issued on March 23, 2020, they used hospital administrative data to perform a retrospective observational analysis of interfacility ED-to-ED transfers to a single adult tertiary care ED. They used a multivariable logistic regression model to investigate the relationship between the lockdown order and the likelihood that a transfer will be classified as a PAT. The PAT classification was used to identify transfers who were quickly discharged from the ED or hospital and may not need in-person care. When comparing the dates March 24, 2020, to September 30, 2020, with January 1, 2018, to March 23, 2020, they took into account seasonality, patient, and situational considerations.
A total of 4,806 (23%) of the 20,978 ED-to-ED transfers eligible during the time period fulfilled the PAT criteria. Although PATs decreased (28%) in the first month following the lockout, the change was not long-lasting. There was a large seasonal influence in the multivariable model; May through September had the highest number of transfers and PATs. PATs reduced with time, and the lockdown was not linked with them (adjusted odds ratio [aOR] 0.99, 95% CI: 0.2, 5.2).
Despite a substantial seasonal influence and a general decreased trend in PATs over time, they could not detect any impact of the COVID-19 lockout on PATs.