(O-G1) Trends in Emergency Department Visits for Alcohol Abuse Following the Arrival of COVID-19

Objectives: Our goal was to determine whether there was a change in the proportion of ED visits for alcohol abuse following the arrival of COVID-19

Background: In March 2020, COVID-19 arrived in the NY Metropolitan area. Total ED visits decreased markedly, likely because of fear of exposure to the virus as well as social isolation mandates. Isolation from peers, job disruptions and quarantining within families led to increased anxiety in the population and this may have led to increased alcohol abuse. A CDC study showed that despite decreased total ED visits, compared to 2019, the proportion of ED mental health-related visits in 2020 increased.

Methods:

Design: Retrospective cohort. Setting: Emergency Departments of 8 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban, and urban areas. Total annual ED volumes in 2019 were 30,000 to 120,000. Population: Consecutive patients seen by ED healthcare providers between March 1 and November 30 in 2019 – 2022, as COVID arrived in March 2020. Data analysis: We identified patients with alcohol abuse using International Classification of Disease codes (ICD, version 10). We tallied the number of ED visits for ICD alcohol diagnoses with at least 100 visits over the four years. We calculated the proportion of these visits to total ED visits in 2019 - 2022. We report the changes in these proportions from the baseline of 2019 to 2020 - 2022, along with 95% confidence intervals (CIs).

Results: The database contained 1,542,684 visits, 485,826, 335,613, 343,152 and 378,093 in 2019, 2020, 2021 and 2022, respectively, of which 25,618 (1.7%) had the diagnosis of alcohol abuse (8718, 7112, 5154 and 4634, respectively, in each of the years). The median ages for each of these years were 46, 46, 45 and 45 years, respectively and the percent female were 27%, 25%, 24% and 24%, respectively. The changes in the proportion of ED Visits for alcohol abuse in each of 2020, 2021 and 2022, compared to the baseline of 2019, were +18% (95% CI: +14, +22%), -21% (95% CI: -24, -19%), and -34% (95% CI: -36, -31%), respectively.

Conclusions: The proportion of ED visits for alcohol abuse increased in 2020 following the arrival of COVID-19, but then decreased in 2021 and 2022. The initial rise may reflect increases in anxiety in the general population, but we do not have an explanation for the decreases in 2021 and 2022.

References (Optional):

Funding (Optional): none