Comparison of emergency department utilization trends between the COVID-19 pandemic and control period

Kang, Soo Young; Ahn, Tae Kyu; Seo, Young Ho; Suh, Young Ju; Paik, Jin Hui

doi:10.1097/md.0000000000026847

Cited by 10 publications

(15 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A statistic report in the United States revealed a significant decline in emergency department (ED) visits during the pandemic. 6 Moreover, this trend was observed in Korea, 7 the Netherlands, 8 and Canada. 9 Furthermore, ED visits for some acute life-threatening events declined during the pandemic, such as myocardial infarction (23% decline) and stroke (20% decline).…”

Section: Introductionmentioning

confidence: 71%

Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis

Yeh¹,

Chien²,

Lee³

et al. 2022

IJGM

View full text Add to dashboard Cite

Purpose During the coronavirus disease 2019 (COVID-19) pandemic, visits to emergency department (ED) have significantly declined worldwide. The purpose of this study was to identify the trend of visits to ED for different diseases at the peak and slack stages of the epidemic. Patients and Methods This was a retrospective observational study conducted in a tertiary referral medical center in northern Taiwan. We recorded weekly ED visits for myocardial infarction with or without ST-elevation (STEMI or NSTEMI), out-of-hospital cardiac arrest (OHCA), acute stroke, and congestive heart failure from 2016 to 2021. We compared the local epidemic peak periods (calendar weeks 4–18, 2020 and calendar weeks 21–31, 2021) and its corresponding slack periods (calendar weeks 4–18, 2021 and calendar weeks 21–31, 2020) with the baseline period (2016–2019) using Mann–Whitney test to identify the difference. Results We observed a significant decline in ED visits (median [Q1, Q3]) during the epidemic for OHCA (6 [5, 7] and 5 [4, 6], p = 0.046, for baseline and peak period, respectively, in week 4–18), acute stroke (41.5 [38, 47] and 35 [28, 39], p < 0.001, in week 4–18, 40 [35, 45] and 35 [28, 40], p = 0.039, in week 21–31) and CHF (28 [24.25, 33] and 19 [12, 23], p < 0.001, in week 4–18, 18 [16, 23] and 13 [11, 16], p = 0.001, in week 21–31). Significant difference was not observed in patients with NSTEMI and STEMI in both week 4–18 and 21–31, and cardiac arrest in week 21–31. There was a rebound in ED visits in the slack period. Conclusion This study revealed that ED visits significantly declined during the COVID-19 epidemic and rebounded in the slack period. The trend was significant for acute stroke and heart failure but was relatively less prominent effect for emergent events such as cardiac arrest or myocardial infarction.

show abstract

Section: Introductionmentioning

confidence: 71%

Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis

Yeh¹,

Chien²,

Lee³

et al. 2022

IJGM

View full text Add to dashboard Cite

show abstract

“…Third, the geospatial projection algorithm of the IQVIA data was not validated during the COVID-19 period. Finally, while data from other jurisdictions support that a reduction in respiratory infections drove the observed change in visit behavior, this study did not examine infectious etiology directly [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 96%

The Impact of COVID-19 on Outpatient Antibiotic Prescriptions in Ontario, Canada; An Interrupted Time Series Analysis

Kitano

Brown

Daneman

et al. 2021

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background The coronavirus disease 2019 (COVID-19) pandemic has potentially impacted outpatient antibiotic prescribing. Investigating this impact may identify stewardship opportunities in the ongoing COVID-19 period and beyond. Methods We conducted an interrupted time series analysis on outpatient antibiotic prescriptions and antibiotic prescriptions/patient visits in Ontario, Canada, between January 2017 and December 2020 to evaluate the impact of the COVID-19 pandemic on population-level antibiotic prescribing by prescriber specialty, patient demographics, and conditions. Results In the evaluated COVID-19 period (March–December 2020), there was a 31.2% (95% CI, 27.0% to 35.1%) relative reduction in total antibiotic prescriptions. Total outpatient antibiotic prescriptions decreased during the COVID-19 period by 37.1% (95% CI, 32.5% to 41.3%) among family physicians, 30.7% (95% CI, 25.8% to 35.2%) among subspecialist physicians, 12.1% (95% CI, 4.4% to 19.2%) among dentists, and 25.7% (95% CI, 21.4% to 29.8%) among other prescribers. Antibiotics indicated for respiratory infections decreased by 43.7% (95% CI, 38.4% to 48.6%). Total patient visits and visits for respiratory infections decreased by 10.7% (95% CI, 5.4% to 15.6%) and 49.9% (95% CI, 43.1% to 55.9%). Total antibiotic prescriptions/1000 visits decreased by 27.5% (95% CI, 21.5% to 33.0%), while antibiotics indicated for respiratory infections/1000 visits with respiratory infections only decreased by 6.8% (95% CI, 2.7% to 10.8%). Conclusions The reduction in outpatient antibiotic prescribing during the COVID-19 pandemic was driven by less antibiotic prescribing for respiratory indications and largely explained by decreased visits for respiratory infections.

show abstract

“…The COVID-19 pandemic causes various impacts on human activity including the emergency visit and hospitalization ( 14 – 16 ), this phenomenon was reported in the other respiratory infectious diseases included severe acute respiratory syndrome ( 17 ), middle east respiratory syndrome coronavirus ( 18 ), and the novel influenza A ( 19 ). Therefore, the COVID-19 pandemic might change the characteristics of emergency hospitalization due to ERD, it is necessary to identify these changes and focus more on improving the care of non-COVID-19 emergency patients during the current pandemic because the mortality was high for emergency visits due to ERD ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Emergency hospitalization caused by non-COVID-19 respiratory diseases before and during the COVID-19 pandemic: A retrospective observational cohort study

Liu

Lin²,

Zhu³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic as well as the subsequent prevention and control measures is like a quasi-experiment intervention that might have changed the features of emergency hospitalizations. Mortality is high in patient hospitalization due to emergency respiratory diseases (ERD). Therefore, we compared the characteristics of these patients before and during the pandemic. Exploring this issue might contribute to decision-making of emergency management when most of the resources and attention has been devoted to combat COVID-19.MethodsThis study was a retrospective observational cohort study. All emergency hospitalizations due to ERD from January 1, 2019 to December 31, 2020 in a tertiary hospital in China were included. Data including patients’ age, sex, and clinical outcomes were extracted. Air quality was collected from the official online platform. Clinical characteristics were compared and odds ratios were calculated.ResultsThe ERD hospitalization rate was lower in 2020 than in 2019 (6.4 vs. 4.3%, χ2 = 55.449, P = 0.000) with a 50.65% reduction; however, the patients were older in 2020 than in 2019 (P = 0.000) with a higher proportion of admission to the intensive care unit (ICU) (46 vs. 33.5%, χ2 = 20.423, P = 0.000) and a longer ICU stay (P = 0.000). The overall intubation rate, hospital mortality, and rate of discharge due to ineffective treatment in 2020 were higher than those in 2019 (15.6 vs. 8%, χ2 = 18.578, P = 0.000; 4.2 vs. 1.1%, χ2 = 4.122, P = 0.000; 5.5 vs. 2.4%, χ2 = 8.93, P = 0.000, respectively). The logistic regression analysis indicated hospitalizations due to ERD were mainly associated with PM2.5 and sulfur dioxide on the day, and on the 4th and 5th days before admission (P = 0.034 and 0.020, 0.021 and 0.000, 0.028, and 0.027, respectively) in 2019. However, in 2020, the relationship between parameters of air quality and hospitalization changed.ConclusionThe COVID-19 pandemic has changed the characteristics of emergency hospitalization due to ERD with a larger proportion of severe patients and poorer prognosis. The effect of air quality on emergencies were weakened. During the COVID-19 pandemic, it is necessary to pay more attention to the non-COVID-19 emergency patients.

show abstract

Comparison of emergency department utilization trends between the COVID-19 pandemic and control period

Cited by 10 publications

References 34 publications

Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis

Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis

The Impact of COVID-19 on Outpatient Antibiotic Prescriptions in Ontario, Canada; An Interrupted Time Series Analysis

Emergency hospitalization caused by non-COVID-19 respiratory diseases before and during the COVID-19 pandemic: A retrospective observational cohort study

Contact Info

Product

Resources

About