Changes in emergency department visits by nursing home residents before, during and after the COVID-19 pandemic: Retrospective study

The COVID-19 pandemic significantly impacted emergency department (ED) visits by nursing home (NH) residents, leading to notable shifts in visit rates, characteristics, and outcomes over time. This retrospective study analyzed all-cause ED visits among NH residents aged over 65 at a large Italian hospital from 2019 to 2022. Non-COVID-19 visits declined sharply by 63.8% in 2020 and continued to remain below pre-pandemic levels in the following years. Compared to 2019, the risk of respiratory disease-related visits decreased significantly in 2021 and 2022. Conversely, the risk of mental health-related visits, particularly for neurotic disorders, increased significantly, with a threefold rise in 2021 and a fourfold rise in 2022. Similarly, fracture-related visits nearly doubled in 2021 and remained high in 2022. These findings underscore the pandemic's enduring effects on the health of NH residents and highlight the critical need to strengthen healthcare systems to effectively manage future health crises.