Changes In Non-COVID-19 Emergency Department Visits By Acuity And Insurance Status During The COVID-19 Pandemic

Yu, Jonathan; Hammond, Gmerice; Waken, RJ; Fox, Daniel K.; Maddox, Karen E. Joynt

doi:10.1377/hlthaff.2020.02464

Cited by 20 publications

(16 citation statements)

References 26 publications

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“…This nding was different from that of some previous studies, which demonstrated a signi cant decline in the number of older adults for acute unscheduled care [30,44,45]. Other studies have demonstrated that the volume of highest-acuity patients had the smallest reduction or did not decrease during the pandemic [46,47]. In Saudi Arabia, which implemented a curfew, a more restrictive measure to control virus transmission, patients presenting during the pandemic were more likely to be more urgent with acuity level [48].…”

Section: Discussioncontrasting

confidence: 71%

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan

Chang

Lee

et al. 2022

Preprint

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Background The number of emergency department (ED) visits has significantly declined since the COVID-19 pandemic. In Taiwan, an aging society, it is unknown whether older adults are accessing emergency care during the COVID-19 epidemic. Therefore, this study aimed to investigate the impact of COVID-19 on the ED visits and triage, admission, and intensive care unit (ICU) hospitalization of the geriatric population in a COVID-19-dedicated medical center throughout various periods of the epidemic. Methods A retrospective chart review of ED medical records from April 9 to August 31, 2021 were conducted, and demographic information was obtained from the hospital’s computer database. The period was divided into pre-, early-, peak-, late-, and post-epidemic stages. For statistical analysis, one-way analysis of variance followed by multiple comparison tests (Scheffe’s test) were used. Results A statistically significant decrease in the total number of patients attending the ED was noted during the peak-, late-, and post-epidemic stages. In the post- and pre-epidemic stage, the number of older patients visiting ED was consistent, indicating their earlier visit to ED than the general population. Regarding ICU admission, the total number of patients in late-epidemic stage was smaller than that in pre-epidemic stage; however, the number of older patients was steady, regardless of hospital or ICU admission. Conclusions During the peak of COVID-19 outbreak, the number of ED visits was significantly affected. However, it is noteworthy that as the epidemic was gradually controlled, the older patients resumed their ED visits earlier that the general population as indicated by the surge in their number. Additionally, in the patient group of triage 1 or 2, which represents a true emergency, the number did not show a drastic change.

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Section: Discussioncontrasting

confidence: 71%

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan

Chang

Lee

et al. 2022

Preprint

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“…As elsewhere, in KSA, during the peak times of COVID-19, the number of patients presenting to ED with COVID-19 increased causing alteration in the number of visits of non-COVID-19-related conditions and perhaps a delay in timely care seeking. This might be concluded by the growing body of global knowledge showing that one year after the occurrence of the pandemic, there was a worldwide change in the numbers of non-COVID-19 patients with both critical and noncritical conditions who present to EDs [7][8][9][10]. For instance, many reports at national and international level showed that survivors of car accidents, people presenting with symptoms of possible origin, cardiac, back, or limb pain and infectious diseases significantly decreased during COVID-19 pandemic [4,[7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…This might be concluded by the growing body of global knowledge showing that one year after the occurrence of the pandemic, there was a worldwide change in the numbers of non-COVID-19 patients with both critical and noncritical conditions who present to EDs [7][8][9][10]. For instance, many reports at national and international level showed that survivors of car accidents, people presenting with symptoms of possible origin, cardiac, back, or limb pain and infectious diseases significantly decreased during COVID-19 pandemic [4,[7][8][9][10]. This might have critical consequences on patient mortality and morbidity.…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on the Service of Emergency Department

et al. 2021

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(1) Introduction: the COVID-19 pandemic significantly impacted the number and acuity of emergency departments (ED) patients, specifically those with non-COVID-19-related health problems. However, the exact impact of the COVID-19 pandemic on ED services is the subject of comprehensive debate. (2) Aim: to gain insight into the consequences of the first wave of the COVID-19 pandemic based on non-COVID-19 presentations and patient acuity using the Canadian Triage and Acuity Scale (CTAS). (3) Method: in Phase 1, the ED records of one of the main regional non-COVID-19 hospitals in Saudi Arabia were retrospectively audited from August 2020 to February 2021—after the first wave of COVID-19—then compared to information collected for the same period in previous year. Phase 2 included calculating the waiting time to identify delays and issues that may impact the triage effectiveness. (4) Results: a change across all CTAS levels was observed post the 1st wave of COVID-19 pandemic. Specifically, there was an increase in the number of patients presenting as higher acuity (CTAS 1 and 2) and a decrease in patients presenting as lower acuity (CTAS 4 and 5). Longer waiting times for patients presenting to ED were also reported. Specifically, 83% of patients presenting as higher acuity experienced a delay. (5) Conclusion: further studies are required to investigate association between the 1st wave of COVID-19 and patient presentations and/or acuity or patient demand and ED capacity.

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“…Secondly, the rate of attendance to A&E with epistaxis was much lower in the post-implementation period, with a reduction seen of almost 12 per month. The post-implementation period was during the second wave of the covid-19 pandemic, when reductions in non-covid A&E attendances were seen across the world, for example in the UK, Italy and the USA [20][21][22] . It is possible that fear of attending A&E meant that patients only attended when epistaxis was severe.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic acid soaked NasoPore® to improve the management of epistaxis

Rosario

Sharma

Patel

et al. 2022

Preprint

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Objectives The aim of this study was to assess the efficacy of a new emergency department intervention for the management of epistaxis, aiming to reduce epistaxis admissions. Design Tranexamic acid (TXA) (500mg/ml) soaked NasoPore® packing was in the pathway for epistaxis which did not terminate following 10 minutes of simple first aid. The pathway was utilised for adult patients presenting with non-traumatic, anterior epistaxis. Pre- and post-implementation admission rates and re-attendance rates were recorded by retrospective audit at a large central London hospital. Results Epistaxis admissions were reduced by 51.7% (p<0.05) following the implementation of the TXA-soaked NasoPore® pathway. Conclusions The significant reduction in epistaxis admissions demonstrates that this intervention is beneficial for patient outcomes. This has the potential to be introduced in other A&E departments and also pre-hospital settings.

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Changes In Non-COVID-19 Emergency Department Visits By Acuity And Insurance Status During The COVID-19 Pandemic

Cited by 20 publications

References 26 publications

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan

The Impact of COVID-19 on the Service of Emergency Department

Tranexamic acid soaked NasoPore® to improve the management of epistaxis

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