Changes in the Pattern of Use of the Emergency Departments in an Spanish Oversaturated Tertiary Hospital Complex During COVID-19 Pandemic

  1. Javier Lacorzana 1
  2. Miguel González-Andrades 2
  3. Santiago Ortiz-Pérez 1
  1. 1 Virgen de las Nieves University Hospital, Granada,
  2. 2 Universidad de Córdoba
    info

    Universidad de Córdoba

    Córdoba, España

    ROR https://ror.org/05yc77b46

Journal:
Actualidad médica

ISSN: 0365-7965

Year of publication: 2022

Tome: 107

Issue: 815

Pages: 27-33

Type: Article

DOI: 10.15568/AM.2022.815.OR03 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Actualidad médica

Abstract

Background and objectives: To analyze the effects of COVID-19 in the pattern of use (number of admissions, hospitalizations, hospitalization ratio, and classification by priorities) of Emergency Departments (EDs) of one tertiary referral hospital. Methods: Retrospective, observational and single-center study, carried on in the EDs of Virgen de las Nieves Hospital Complex (Granada, Spain). The information was collected from the three hospitals which belong to the Virgen de las Nieves Hospital complex (i.e. the General Hospital, GH; the Children’s Hospital, CH; and the Neuro-Trauma Hospital, NTH) from February 1st to July 31st, 2019, and 2020. Results: In the period under analysis, there were 71236 admissions compared with 118382 in the same period in 2019, which means an overall reduction of 38.83%. Considering the hospitalizations, there were 6841 compared with 7648 (2020 and 2019, respectively) which gives an overall reduction of 10.55%. The distribution of the priorities did not show a defined pattern; while CH and NTH’s EDs showed clear changes in their distribution, no notable changes were observed in GH’s ED. Conclusion: The Covid-19 Pandemic changed dramatically the pattern of ED referral in our tertiary referral hospital. A noticeable reduction of admissions and hospitalizations were reported, together with a pronounced increase in the hospitalization ratio that in some cases reached almost 50%. This could be explaining for many reasons, such as the fear of contagion and the lockdown that presumably caused a decrease in the less-severe cases attended. Possibly, the effects of COVID-19 may have been indirectly influenced by the health care system of each country. The COVID-19 pandemic constitutes one of the greatest challenges in modern medicine, understanding better these changes and the impact that COVID-19 has caused on pattern of use of EDs will probably lead us to manage and use better our public health systems in the future.

Bibliographic References

  • Azeredo TRM, Guedes HM, Rebelo de Almeida RA, Chianca TCM, Martins JCA. Efficacy of the manchester triage system: A systematic review. Vol. 23, International Emergency Nursing. Elsevier Ltd; 2015. p. 47–52. DOI: 1016/j.ienj.2014.06.001
  • Bellan M, Gavelli F, Hayden E, Patrucco F, Soddu D, Pedrinelli AR, et al. Pattern of emergency department referral during the Covid-19 outbreak in Italy. Panminerva Med. 2020; DOI: 23736/S0031-0808.20.04000-8
  • Bjørnsen LP, Næss-Pleym LE, Dale J, Laugsand LE. Pasienttilstromming i et akuttmottak i pavente av covid-19-pandemien. Tidsskr den Nor Laegeforening. 2020; 140 (8):1–5. DOI: 4045/tidsskr.20.0277
  • Bokolo Anthony Jnr. Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst. 2020 Jul 1; 44 (7). DOI: 1007/s10916-020-01596-5
  • Clavenna A, Nardelli S, Sala D, Fontana M, Biondi A, Bonati M. Impact of COVID-19 on the Pattern of Access to a Pediatric Emergency Department in the Lombardy Region, Italy. Pediatr Emerg Care. 2020 Oct 1; 36 (10):e597–8. DOI: 1097/PEC.0000000000002232
  • Contreras CM, Metzger GA, Beane JD, Dedhia PH, Ejaz A, Pawlik TM. Telemedicine: Patient-Provider Clinical Engagement During the COVID-19 Pandemic and Beyond. Vol. 24, Journal of Gastrointestinal Surgery. Springer; 2020. p. 1692–7. DOI: 1007/s11605-020-04623-5
  • COVID-19 Map – Johns Hopkins Coronavirus Resource Center [Internet]. [cited 2021 Apr 7]. Available from: https://coronavirus.jhu.edu/map.html
  • Fagoonee I, Pellicano R. COVID-19 brings the world economy to its knees. Minerva Med. 2020 Aug 1; 111 (4):297–9. DOI: 23736/S0026-4806.20.06603-3
  • Kickbusch I, Leung GM, Bhutta ZA, Matsoso MP, Ihekweazu C, Abbasi K. Covid-19: How a virus is turning the world upside down. 369, The BMJ. BMJ Publishing Group; 2020. DOI: 10.1136/bmj.m1336
  • Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Vol. 4, The Lancet Child and Adolescent Health. Elsevier B.V.; 2020. p. e10–1. DOI: 1016/S2352-4642 (20)30108-5
  • Leibner ES, Stokes S, Ahmad D, Legome E. Emergency department COVID management policies: one institution’s experience and lessons learned. Emerg Med Pract. 2020 May 4; 22 (5):1.
  • McIntyre A, Tong K, McMahon E, Doherty AM. COVID-19 and its Effect on Emergency Presentations to a Tertiary Hospital with Self-Harm in Ireland. Ir J Psychol Med. 2020 Sep 30; 1–20. DOI: 1017/ipm.2020.116
  • Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A, Farokhi E, Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol. 2020 May 1; 126. DOI: 1016/j.jcv.2020.104345
  • Montaner J, Barragán-Prieto A, Pérez-Sánchez S, Escudero-Martínez I, Moniche F, Sánchez-Miura JA, et al. Break in the Stroke Chain of Survival Due to COVID-19. 2020 May 29; STROKEAHA120030106. DOI: 10.1161/STROKEAHA.120.030106
  • Naouri D, Naouri D, Ranchon G, Vuagnat A, Schmidt J, Schmidt J, et al. Factors associated with inappropriate use of emergency departments: Findings from a cross-sectional national study in France. BMJ Qual Saf. 2020 Jun 1; 29 (6):449–64. DOI: 1136/bmjqs-2019-009396
  • Ohannessian R, Duong TA, Odone A. Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action. JMIR Public Heal Surveill. 2020 Apr 2; 6 (2):e18810. DOI: 2196/18810
  • Ojetti V, Covino M, Brigida M, Petruzziello C, Saviano A, Migneco A, et al. Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Medicina (B Aires). 2020 Oct 1; 56 (10):512. DOI: 3390/medicina56100512
  • Pinto S. Coronavirus disease 2019 (COVID-19): Myocardial infarction and other coronary artery disease issues – UpToDate [Internet]. [cited 2020 Nov 7]. Available from: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-myocardial-infarction-and-other-coronary-artery-disease-issues
  • Raman R, Madhusudan M. Impact of the COVID-19 Pandemic on Admissions to the Pediatric Emergency Department in a Tertiary Care Hospital. Indian J Pediatr. 2020 Nov 4; 1. DOI: 1007/s12098-020-03562-y
  • Storm-Versloot MN, Ubbink DT, Kappelhof J, Luitse JSK. Comparison of an Informally Structured Triage System, the Emergency Severity Index, and the Manchester Triage System to Distinguish Patient Priority in the Emergency Department. Acad Emerg Med. 2011 Aug 1; 18 (8):822–9. DOI: 1111/j.1553-2712.2011.01122.x
Data source: Dialnet