Adult emergency department visits during the COVID-19 pandemic in Veneto region, Italy: a time-trend Analysis

Paganini, Matteo; Amidei, Claudio Barbiellini; Valastro, Maria Francesca; Favarò, Antonio; Saïa, Mario; Buja, Alessandra

doi:10.1007/s11739-021-02815-8

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Parents may also have avoided attending hospital due to the expectation of overcrowding and long wait times, as reported for adult EDs in the Lombardy and Piedmont areas heavily affected by COVID-19 during this period [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

et al. 2021

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During the initial phase of the national lockdown, we found that there were sharp decreases in admissions to two pediatric emergency departments (EDs) in northern Italy (Cremona and Novara). Here we present a detailed analysis of these admission patterns and types of admissions over a longer timeframe. ED admissions data were anonymously extracted from the departmental management software. Admissions data from 2019 and 2020 were analyzed and compared separately for each ED and combined. There was a 73.2% decrease in total admissions compared with the same period in 2019. With respect to admission diagnoses, there was a significant (p < 0.001) drop in infectious (−51%), respiratory (−25.5%), and nervous systems diseases (−50%) and injuries and poisoning (−17%) but not endocrine, metabolic, neoplastic, circulatory, or musculoskeletal diseases. White codes (patients with minor injuries for whom ED medical care is not required) significantly decreased by 56.3% (p < 0.001). Even if the COVID-19 pandemic represented an enormous healthcare burden in Italy, especially during the first months of the pandemic (late February to May), the workload of pediatric EDs was significantly reduced, especially for unnecessary accesses (white codes).

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Section: Discussionmentioning

confidence: 99%

Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

et al. 2021

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“…This reorganization also reshaped emergency care, as well as patients' behaviors and attitudes towards healthcare services. During the first weeks of the COVID-19 pandemic, a strong reduction in emergency department (ED) visits was reported in many countries [3][4][5][6][7][8][9][10][11][12][13][14][15] due to patients' fear of becoming infected. This delay in seeking medical attention could have negatively affected patients' management and outcomes, especially when dealing with life-threating or oncological conditions [16][17][18][19], but also with other time-dependent medical emergencies/urgencies [20].…”

Section: Introductionmentioning

confidence: 99%

The Adverse Impact of the COVID-19 Pandemic on Abdominal Emergencies: A Retrospective Clinico-Pathological Analysis

Vissio

Falco

Scozzari

et al. 2021

JCM

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The COVID-19 pandemic has caused a worldwide significant drop of admissions to the emergency department (ED). The aim of the study was to retrospectively investigate the pandemic impact on ED admissions, management, and severity of three abdominal emergencies (appendicitis, diverticulitis, and cholecystitis) during the COVID-19 pandemic using 2017–2019 data as a control. The difference in clinical and pathological disease severity was the primary outcome measure while differences in (i) ED admissions, (ii) triage urgency codes, and (iii) surgical rates were the second ones. Overall, ED admissions for the selected conditions decreased by 34.9% during the pandemic (control: 996, 2020: 648) and lower triage urgency codes were assigned for cholecystitis (control: 170/556, 2020: 66/356, p < 0.001) and appendicitis (control: 40/178, 2020: 21/157, p = 0.031). Less surgical procedures were performed in 2020 (control: 447, 2020: 309), but the surgical rate was stable (47.7% in 2020 vs. 44.8% in 2017–2019). Considering the clinical and pathological assessments, a higher percentage of severe cases was observed in the four pandemic peak months of 2020 (control: 98/192, 2020: 87/109; p < 0.001 and control: 105/192, 2020: 87/109; p < 0.001). For the first time in this study, pathological findings objectively demonstrated an increased disease severity of the analyzed conditions during the early COVID-19 pandemic.

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“…The COVID-19 pandemic has posed a dramatic, unexpected, and unprecedented burden on many healthcare systems worldwide. Universally decreased numbers of ED visits by age, disease categories, and the characteristics and case severity of patients have been revealed by anecdotal reports [18][19][20][21][22][23][24][25][26][27][28][29][31][32][33][34][35][36]. Most studies originated from severe pandemic areas that analyzed the change in the early stage (4-8 weeks) of the COVID-19 outbreak and reported a significant decrease, ranging from 31.0 to 63.5%, in ED patient flow compared to a historical control period [18,19,21,23,27,31,34].…”

Section: Impact Of Covid-19 On Ed Attendance In the Initial And Later...mentioning

confidence: 99%

“…Universally decreased numbers of ED visits by age, disease categories, and the characteristics and case severity of patients have been revealed by anecdotal reports [18][19][20][21][22][23][24][25][26][27][28][29][31][32][33][34][35][36]. Most studies originated from severe pandemic areas that analyzed the change in the early stage (4-8 weeks) of the COVID-19 outbreak and reported a significant decrease, ranging from 31.0 to 63.5%, in ED patient flow compared to a historical control period [18,19,21,23,27,31,34]. During the initial phase, we found some similarities regarding a reduction in in ED visits, especially in pediatric and ambulatory patients, among the compared countries where the pandemic was serious [20,21,26,27,31].…”

Section: Impact Of Covid-19 On Ed Attendance In the Initial And Later...mentioning

confidence: 99%

“…Identifying changes in the pattern of patient flow in the ED is important for preparedness and mitigation. During the early days of the COVID-19 pandemic, a characteristic change and significant decrease in the number of patients who came to the ED with complaints unrelated to COVID-19 was reported [18][19][20][21][22][23][24][25][26][27][28][29], mostly in devastated regions, limited sections, or only for a short period of observation. However, the impact of patient flow throughout the pandemic year on the ED of a tertiary hospital, in a low-prevalence region, has not been comprehensively examined, especially in a health system that from April to December 2020 (i.e., 253 days) had no locally transmitted cases reported [30].…”

Section: Introductionmentioning

confidence: 99%

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Examining patient flow in a tertiary hospital’s emergency department at a low coronavirus prevalence region

Tseng

Lin

et al. 2022

BMC Emerg Med

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Background Taiwan’s successful containment of the COVID-19 outbreak prior to 2021 provided a unique environment for the surveillance of unnecessary emergency medical use. The aim of the study is to examine the impact of the coronavirus disease (COVID-19) pandemic on the patient flow in the emergency department (ED) of a tertiary hospital over 1 year in southern Taiwan, a region with low COVID-19 prevalence. Methods Cross-sectional observational study was conducted from January to December 2020. Essential parameters of patient flow in the ED between January and February 2020 and the subsequent 11-month period were compared to data from 2019. Data were analyzed with descriptive statistics, using an independent sample t-test or Mann–Whitney U test, as applicable. Results The ED census showed an acute decline (− 30.8%) from January to February 2020, reaching its nadir (− 40.5%) in April 2020. From February to December 2020, there was an average decrease of 20.3% in ED attendance (p < 0.001). The impact was most significant in ambulatory visits, lower-urgency acuity (level III) visits, and pediatric visits, without change in the acuity proportion. The length of stay shortened mainly in the adult division, which typically had an overcrowding problem (median, 5.7–4.4 hours in discharge; 24.8–16.9 hours in hospitalization; p < 0.001). The incidence of 72-hour unscheduled return visits was also reduced (4.1–3.5%, p = 0.002). Conclusions In contrast to devastated regions, the impact on the ED patient flow in regions having low COVID-19 prevalence highlights a remodeling process of emergency medical care that would improve overcrowding.

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Adult emergency department visits during the COVID-19 pandemic in Veneto region, Italy: a time-trend Analysis

Cited by 9 publications

References 15 publications

Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

The Adverse Impact of the COVID-19 Pandemic on Abdominal Emergencies: A Retrospective Clinico-Pathological Analysis

Examining patient flow in a tertiary hospital’s emergency department at a low coronavirus prevalence region

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