The Emergency Performance of the Hungarian Ambulance Service during the COVID-19 Pandemic

Bíró, Klára; Deák, Máté Sándor; Pápai, György; Nagy, Attila; Dombrádi, Viktor; Szabó, Gábor; Boruzs, Klára; Bányai, Gábor; Csató, Gábor

doi:10.3390/healthcare10112331

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…For instance, during the COVID-19 pandemic, despite the overall preparedness of the healthcare service, criticalities emerged concerning the insufficiency of healthcare structures to accommodate patients who, ready for discharge from hospital, were not yet in an appropriate condition to treat themselves independently at home [ 46 ]. This lead both to an abnormal use of emergency services and inpatient wards bottlenecking [ 47 , 48 , 49 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Pietrantonio,

Vinci,

Maurici

et al. 2023

Sensors

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Background: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. Methods: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient’s perspective). In this perspective paper, the main findings of these studies, from the operators’ point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. Results: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. Conclusions: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases.

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Section: Discussionmentioning

confidence: 99%

Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Pietrantonio,

Vinci,

Maurici

et al. 2023

Sensors

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Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study

Lindskou,

Bogh,

Kløjgaard

et al. 2024

Scand J Trauma Resusc Emerg Med

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Background During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic. Furthermore, we investigated the overall mortality of the ambulance population, the main reason for calling the emergency medical dispatch centre, and the diagnosis assigned to the admitted patients. Methods The study was a nationwide registry-based cohort study based on the national prehospital medical records and the Danish National Patient Registry. The primary outcome was the requested number of ambulances. Secondary outcomes included the primary reason for contact with the dispatch centre (reflected by the dispatch criteria), patient mortality, and the diagnoses assigned to the patients transported to the hospital by ambulance during the COVID-19 pandemic in Denmark in March–December 2020. Comparisons were made using a similar period in 2019 before the pandemic. Results In comparison with the baseline values before the pandemic, the total number of patients treated by the EMS was reduced by 4.5% during the COVID-19 pandemic. The number of patients transported to the hospital during the pandemic was similarly reduced by 3.5%. Compared with baseline values, fewer were patients hospitalised with respiratory diseases during the pandemic (a reduction of 53.3% from April 2019 to April 2020). Compared to the baseline period, there were significant increases in both the 48-h mortality (from 1.4% to 1.5%) and the 30-day mortality (from 4.9% to 5.4%) (p < 0.03 and p < 0.001, respectively), in patients hospitalised during the pandemic. Conclusion During the first wave of the COVID-19 pandemic, the Danish EMS experienced an overall reduction in the requests for and the use of ambulances and, especially, in the number of patients admitted to hospitals for respiratory diseases. Despite the overall reduction in EMS requests, the mortality of the ambulance population increased, indicating that despite the reduced ambulance use, the prehospital population was more severely ill during the pandemic.

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Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy

Furia

Vinci

Colamesta³

et al. 2023

Front. Public Health

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BackgroundFrequent users (FUs) are patients who repeatedly and inappropriately visit the emergency department (ED) for low-grade symptoms that could be treated outside the hospital setting. This study aimed to investigate the phenomenon of the FU in Rome by profiling such users and analyzing ED attendance by FUs.MethodsThe analysis was carried out for attendance in 2021 at 15 EDs in the Local Health Authority Roma 1 geographical area. A digital app collected data, including information on the following variables: number of attendance, demographic characteristics, emergency medical service (EMS) usage, triage code, and appropriateness of attendance. COVID-19 diagnosis was also studied to analyze any possible influence on ED attendance. Differences between FUs and non-FUs were investigated statistically by t-test and chi-square test. Univariate analysis and multivariable logistic regression were performed to analyze the associated factors.ResultsA total of 122,762 ED attendance and 89,036 users were registered. The FU category represented 2.9% of all users, comprising 11.9% of total ED attendance. There was a three times higher frequency of non-urgent codes in attendance of FU patients (FU: 9.7%; non-FU: 3.2%). FUs were slightly more likely to have used the EMS (13.6% vs. 11.4%) and had a lower frequency of appropriate ED attendance (23.8% vs. 27.0%). Multivariate logistic analysis confirmed a significant effect of triage code, gender, age, EMS usage, and COVID-19 diagnosis for the appropriateness of attendance. The results were statistically significant (p < 0.001).ConclusionThe FU profile describes mostly non-urgent and inappropriate attendance at the ED, including during the COVID-19 pandemic. This study represents an important tool for strengthening preventive policies outside the hospital setting. The Italian National Recovery and Resilience Plan represents an excellent opportunity for the development of new strategies to mitigate the phenomenon of FUs.

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The Emergency Performance of the Hungarian Ambulance Service during the COVID-19 Pandemic

Cited by 4 publications

References 30 publications

Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study

Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy

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