Trends in outpatient emergency department census during the COVID-19 pandemic at a California health system

To the Editors, We have read the article entitled: “Trends in outpatient emergency department visits during the COVID-19 pandemic at a large, urban, academic hospital system” by Giannouchos TV, Biskupiak J, Moss MJ, Brixner D, Andreyeva E, and Ukert B, published in the American Journal of Emergency Medicine, Volume 40, Page 20-26, February 2021 [1]. The differences in yearly decline in outpatient ED visits in AHMC (28.3%) compared to the University of Utah Health Emergency Department (8.1%) could be explained by the differences in the population which the hospitals serve. (2021) and AHMC HeathSystem as of 20211Unlabelled TableUniversity of Utah Health Emergency DepartmentAHMC HealthSystemGeographic coverageUtah, Nevada, Wyoming, Idaho, and western ColoradoLos Angeles and Orange Counties, CaliforniaOutpatient ED visits30,276 in 2020 and 32,937 in 2019⁎104,450 in 2020 and 145,726 in 2019Data collection periodJanuary 2019 to August 2020January 2019 to January 2021Health Insurance48.2% Private, 22.0% Medicaid, 17.8% Medicare, and 12.0% Out-of-pocket/Other67.2% Managed Care, 18.9% Medicare, 9.8% Medicaid, and 4.1% Private/Other⁎⁎AHMC data were included from all patients from all inpatient admissions, Emergency Department, and outpatient.