Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington
Abstract 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 morbid...
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| Language: | English |
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Elsevier
2024-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13098 |
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| author | Zachary S. Wettstein Jane Hall Cameron Buck Steven H. Mitchell Jeremy J. Hess |
| author_facet | Zachary S. Wettstein Jane Hall Cameron Buck Steven H. Mitchell Jeremy J. Hess |
| author_sort | Zachary S. Wettstein |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-64da2dec4dcb4bd0a7ba6b1536972d0e |
| institution | Kabale University |
| issn | 2688-1152 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-64da2dec4dcb4bd0a7ba6b1536972d0e2025-08-20T03:34:25ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522024-02-0151n/an/a10.1002/emp2.13098Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, WashingtonZachary S. Wettstein0Jane Hall1Cameron Buck2Steven H. Mitchell3Jeremy J. Hess4Department of Emergency Medicine University of Washington School of Medicine Seattle Washington USADepartment of Emergency Medicine University of Washington School of Medicine Seattle Washington USADepartment of Emergency Medicine University of Washington School of Medicine Seattle Washington USADepartment of Emergency Medicine University of Washington School of Medicine Seattle Washington USADepartment of Emergency Medicine University of Washington School of Medicine Seattle Washington USAAbstract 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.https://doi.org/10.1002/emp2.13098climate changedisasterheatheat waveoperations |
| spellingShingle | Zachary S. Wettstein Jane Hall Cameron Buck Steven H. Mitchell Jeremy J. Hess Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington Journal of the American College of Emergency Physicians Open climate change disaster heat heat wave operations |
| title | Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
| title_full | Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
| title_fullStr | Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
| title_full_unstemmed | Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
| title_short | Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington |
| title_sort | impacts of the 2021 heat dome on emergency department visits hospitalizations and health system operations in three hospitals in seattle washington |
| topic | climate change disaster heat heat wave operations |
| url | https://doi.org/10.1002/emp2.13098 |
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