ER visits down 40%; revenue scrutinized

File photoEmergency room visits are down 40% at Columbia Memorial Health, but all medical procedures are allowed at Capital Region hospitals after the coronavirus shutdown.

HUDSON — Emergency room visits are down 40% at Columbia Memorial Health, though all medical procedures are now allowed in Capital Region hospitals after the coronavirus shutdown.

In addition to emergency room visits, the number of patients visiting specialists such as cardiologists and pulmonologists, and hospital admissions, are also down at CMH compared to pre-COVID times, even though prohibitions on nonessential and elective medical procedures and tests have been lifted by Gov. Andrew Cuomo.

Columbia Memorial Health is not in danger of closing because of the reductions in patient volume, as other hospitals around the country have reported, said CMH Chief Medical Officer Dr. Clifford Belden.

“We are not in danger of closing, but we are watching the revenue,” Belden said.

In April, CMH furloughed 125 employees as demand for medical care declined at the height of the pandemic.

Columbia Memorial Health spokesman William Van Slyke said the impact on many hospitals was deep.

“The reductions in volume of numerous services that CMH and most health care systems experienced were significant,” Van Slyke said.

Columbia Memorial administrators meet twice a week to review which furloughed employees can be brought back as the workload increases, Belden said.

The operating room, which is now up and running, has seen the return of some employees, as have some of the CMH clinics around the Twin Counties, Belden said.

“Many of the clinics have had employees who left now come back,” Belden said. “During the peak of the COVID experience for our area, the clinic volumes were down 50%, 70%, in that range, because there weren’t telehealth visits and many people didn’t feel comfortable going out. Some of those employees have been brought back now that the volume is back.”

The number of furloughed employees that have returned to work was not available, Van Slyke said.

Beginning in mid-March, all elective procedures were banned under Gov. Andrew Cuomo’s NY on PAUSE executive order, but like other areas of the economy, permitted activities in hospitals have been expanding as the number of coronavirus cases declines statewide.

With the reopening, CMH is now offering all of its usual services, including medical procedures and testing, such as 3-D mammography, MRIs, ultrasound exams and the like.

“For about a month now, we had the go-ahead to perform elective outpatient procedures, and then after a few weeks they opened it up so all procedures could be performed,” Belden said.

Hospital officials are encouraging local residents not to ignore symptoms and visit a doctor if they need to.

Columbia Memorial and its clinics around the Twin Counties have implemented precautions to protect patients from COVID-19, but some patients who are high-risk for the virus should refrain from unnecessary procedures, Belden said.

“Someone who is very frail or ill and can postpone a procedure, I think this is not the best time to get the procedure done if there are other health concerns, but for the vast majority of patients, we are open and performing procedures in a safe manner,” Belden said.

The reduction in emergency room visits at CMH mirrors a nationwide trend.

“Nationally, there has been a 40% reduction in emergency department visits, which is a huge number,” said Dr. Ferdinand J. Venditti, hospital general director of Albany Medical Center.

At the peak of the public health crisis, visits to doctors’ offices were down around 50% statewide, Belden said.

“We have seen those creep back up, so it’s probably closer to 80% or so of the normal number of visits that we are seeing in our offices overall,” he added.

While the number of visits to the emergency room is down by roughly 40%, and visits to specialists such as cardiologists and pulmonologists have also declined, primary care visits are at about 90% to 95% of typical capacity, Belden said.

“The concern is that people are ignoring some of their chronic or acute medical conditions that need treatment or need to be seen by a doctor because of fear of the coronavirus,” Belden said. “I believe that is a contributor to the increase in death rates that we saw in New York state from March 15 to the end of May.”

For example, deaths due to heart disease tripled during the pandemic, Belden said.

“I think people were staying away from the doctors, they were staying away from emergency rooms, and we want those people that have chronic medical conditions to know we are practicing social distancing, our staff are wearing masks, patients are wearing masks, exam rooms are disinfected,” Belden said.

People who don’t feel comfortable going for an in-person visit have other options, such as telehealth or telephone visits, Belden said.

Fear of the coronavirus may not be the only factor in reduced visits to the emergency room and some specialists, Belden said. There may be fewer traffic accidents and recreational sports-related injuries because people are staying home more, but the trend appears across the board in some departments.

“There is a sustained and true drop in emergency room visits and it’s everything — chest pain, urinary tract infections, respiratory symptoms. All of them are down compared to last year at this time, or even in February of this year,” he said. “People may be healthier, but they could be ignoring symptoms or not coming to the emergency room for symptoms that should be looked at.”

Johnson Newspapers 7.1

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