Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington
© 2024 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians..
Objectives: Extreme heat events (EHEs) are associated with excess healthcare utilization but specific impacts on emergency department (ED) operations and throughput are unknown. In 2021, the Pacific Northwest experienced an unprecedented heat dome that resulted in substantial regional morbidity and mortality. The aim of this study was to examine its impact on ED utilization, unplanned hospitalization, and hospital operations in a large academic healthcare system.
Methods: Retrospective electronic medical records from three Seattle-area hospitals were used to compare healthcare utilization during the EHE compared to a pre-event reference period within the same month. Interrupted time series analysis was used to evaluate the association between EHE exposure and ED visits and hospitalizations. Metrics of ED crowding for the EHE were compared to the reference period using Student's t-tests and chi-squared tests. Additionally, multivariable Poisson regression was used to identify risk factors for heat-related illness and hospital admission.
Results: Interrupted time series analysis showed an increase of 21.7 ED visits per day (95% confidence interval [CI] = 14.7, 28.6) and 9.9 unplanned hospitalizations per day (95% CI = 8.3, 11.5) during the EHE, as compared to the reference period. ED crowding and process measures also displayed significant increases, becoming the most pronounced by day 3 of the EHE; the EHE was associated with delays in ED length of stay of 1.0 h (95% CI = 0.4, 1.6) compared to the reference period. Higher incidence rate ratios for heat-related illness were observed for patients who were older (incidence rate ratio [IRR] = 1.02; 95% CI = 1.01,1.03), female (IRR = 1.47; 95% CI = 1.06, 2.04), or who had pre-existing diabetes (IRR = 3.19; 95% CI = 1.47, 6.94).
Conclusions: The 2021 heat dome was associated with a significant increase in healthcare utilization including ED visits and unplanned hospitalizations. Substantial impacts on ED and hospital throughput were also noted. These findings contribute to the understanding of the role extreme heat events play on impacting patient outcomes and healthcare system function.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Journal of the American College of Emergency Physicians open - 5(2024), 1 vom: 20. Jan., Seite e13098 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wettstein, Zachary S [VerfasserIn] |
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| Links: |
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| Themen: |
Climate change |
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| Anmerkungen: |
Date Revised 23.01.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/emp2.13098 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367406942 |
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| 100 | 1 | |a Wettstein, Zachary S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2024 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. | ||
| 520 | |a Objectives: Extreme heat events (EHEs) are associated with excess healthcare utilization but specific impacts on emergency department (ED) operations and throughput are unknown. In 2021, the Pacific Northwest experienced an unprecedented heat dome that resulted in substantial regional morbidity and mortality. The aim of this study was to examine its impact on ED utilization, unplanned hospitalization, and hospital operations in a large academic healthcare system | ||
| 520 | |a Methods: Retrospective electronic medical records from three Seattle-area hospitals were used to compare healthcare utilization during the EHE compared to a pre-event reference period within the same month. Interrupted time series analysis was used to evaluate the association between EHE exposure and ED visits and hospitalizations. Metrics of ED crowding for the EHE were compared to the reference period using Student's t-tests and chi-squared tests. Additionally, multivariable Poisson regression was used to identify risk factors for heat-related illness and hospital admission | ||
| 520 | |a Results: Interrupted time series analysis showed an increase of 21.7 ED visits per day (95% confidence interval [CI] = 14.7, 28.6) and 9.9 unplanned hospitalizations per day (95% CI = 8.3, 11.5) during the EHE, as compared to the reference period. ED crowding and process measures also displayed significant increases, becoming the most pronounced by day 3 of the EHE; the EHE was associated with delays in ED length of stay of 1.0 h (95% CI = 0.4, 1.6) compared to the reference period. Higher incidence rate ratios for heat-related illness were observed for patients who were older (incidence rate ratio [IRR] = 1.02; 95% CI = 1.01,1.03), female (IRR = 1.47; 95% CI = 1.06, 2.04), or who had pre-existing diabetes (IRR = 3.19; 95% CI = 1.47, 6.94) | ||
| 520 | |a Conclusions: The 2021 heat dome was associated with a significant increase in healthcare utilization including ED visits and unplanned hospitalizations. Substantial impacts on ED and hospital throughput were also noted. These findings contribute to the understanding of the role extreme heat events play on impacting patient outcomes and healthcare system function | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a climate change | |
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| 700 | 1 | |a Buck, Cameron |e verfasserin |4 aut | |
| 700 | 1 | |a Mitchell, Steven H |e verfasserin |4 aut | |
| 700 | 1 | |a Hess, Jeremy J |e verfasserin |4 aut | |
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