Trends in Emergency Department Visits, and Hospital Admissions Pre- and During Covid 19 Pandemic

Yıl 2023, , 47 - 57, 31.01.2023

Savaş Sezik , Onur Hakoğlu , Oktay Okuş , Omay Sorgun

https://doi.org/10.47482/acmr.1199056

Cited By: 1

Öz

Background: During the COVID-19 pandemic period, the unnecessary use of the emergency department (ED) affects the motivation of health care providers leading the healthcare services to be far from being efficient, delays the care of the patients having an actual emergency situation and reduces the quality of education in teaching clinics.
Methods: Diagnoses in the visits were classified based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) categories and were analyzed into subgroups based on common reasons for ED visits.
Results: While the number of ED visits in the first year of the pandemic period decreased by 26% compared to the previous year, the frequency of admissions in the circulatory system (CS), stomach and intestinal system (SIS), nervous system (NS), trauma (T), infectious disease (ID), endocrine system (ES), muscular system and connective tissues (MCT), gynecology and pregnancy (GP), environmental emergency (EE), mental and behavioral disorders (MBD), examination and encounter for administrative purposes (EEAP) was higher than expected and the frequency of admission and referral was also significantly more than the expected value (P < 0.001).
Conclusion: In addition to the significant decrease in the number of ED visits during the pandemic, the fact that higher admission and referral frequency were observed indicating that the patients visited the emergency service in the late phases with severe clinical conditions.


Key Words: COVID-19 pandemic, Emergency Departments, ICD Codes, Patient Admission, Outpatients,

Anahtar Kelimeler

COVID-19 pandemic, Emergency Departments, ICD Codes, Patient Admission, Outpatients

Kaynakça

• Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE 3rd, Hoppe JA, Genes N, Nath B, Melnich ER. JAMA Intern Med. 2020;180(10):1328-33.
• Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: systematic literature review. Am J Manag Care. 2013;19(1):47–59.
• Durand AC, Gentile S, Devictor B, Palazzolo S, Vignally G, Gerbeaux P, Sambuc R. ED patients: how nonurgent are they? Systematic review of the emergency medicine literature. Am J Emerg Med. 2011;29(3):333–45.
• Everitt BS. The analysis of contingency tables. London Chapman And Hall, A Halsted Press Book, John Willey and Sons, Inc New York 1977 (first edition), page 46-48. ISBN 0412 14970 2.
• Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The impact of the COVID-19 Pandemic on hospital admission in the United States. Health Aff (Milwood). 2020;39: 201-07.
• Alwood S, Musso MW, Jones GN, Mosley J, Wippel B, Theriot L, Hamer D. The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers. Am J Emerg Med. 2021; 48:114-19
• Santana R, Sousa JS, Soares P, Lopes S, Boto P, Rocha JV. The Demand for Hospital Emergency Services: Trends during the First Month of COVID-19 Response. Port J Public Health 2020;38:30−6.
• Westgard BC, Morgan MW, Vazquez-Benitez G, Erickson LO, Zwank MD. An Analysis of Changes in Emergency Department Visits After a State Decleration During the Time of COVID-19. Ann Emerg Med. 2020;76(5):595-601.
• Baugh JJ, White BA, McEvoy D, Yun BJ, Brown DFM, Raja AS, Dutta S. The cases not seen: Patterns of emergency department visits and procedures in the era of COVID-19. Am J Emer Med 2021;46:476-481.
• Hendrikse C, Parak M, Van Hoving DJ. A descriptive analysis of the effect of the national COVID-19 lockdown on the workload and case mix of patients presenting to a district-level emergency centre in Cape Town, South Africa. S Afr Med J. 2020;110(11):113-18.
• Giamello JD, Abram S, Bernardi S, Lauria G. The emergency department in the COVID-19 era. Who are we missing? Eur J Emerg Med. 2020;27(4):305-06.
• Kansagra AP, Goyal MS, Hamilton S, Albers GW. Collateral Effect of Covid-19 on Stroke Evaluation in the United States. NEJM. 2020;383(4):400-01.
• Bres Bullrich M, Fridman S, Mandzia JL, Mai LM, Khaw A, Vargas Gonzalez JC, Bagur R, Sposato LA. COVID-19: Stroke Admissions, Emergency Department Visits, and Prevention Clinic Referrals. Can J Neurol Sci. 2020;47(5):693-96.
• Erol MK, Kayikcioglu M, Kilickap M, Guler A, Yildirim A, Kahraman F, Can V, Inci S, Baysal SS, Er O, Zeybey U, Kafkas C, Yayla C, Arin CB, Aktas I, Yalcin AA, Genc O. Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study. Anatol J Cardiol. 2020; 24(5):334-42.
• Kuitunen I, Ponkilainen VT, Launonen AP, Reito A, Hevonkorpi TM, Paloneval J, Mattila VM. The effect of national lockdown due to COVID-19 on emergency department visits. Scand J Trauma Resusc Emerg Med. 2020; 28:114.
• Moyer JD, Abback PS, Hamada S, Martinez T, Werner M, James A, Traumabase®Group. Effect of 2020 containment strategies on trauma workflow in Ile-de-France region: another benefit of lockdown? Scand J Trauma Resusc Emerg Med. 2021;29(1):135.
• Nuñez JH, Sallent A, Lakhani K, Guerra-Farfan E, Vidal N, Ekhtiari S, Minguell J. Impact of the COVID-19 Pandemic on an Emergency Traumatology Service: Experience at a Tertiary Trauma Centre in Spain. Injury. 2020 Jul;51(7):1414-18.
• Gonçalves-Pinho M, Mota P, Ribeiro J, Macedo S, Freitas A. The Impact of COVID-19 Pandemic on Psychiatric Emergency Department Visits - A Descriptive Study. Psychiatr Q. 2021 Jun;92(2):621-31.
• Capuzzi E, Di Brita C, Caldiroli A, Colmegra F, Nava R, Buoli M, Clerici M. Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy. Psychiatry Res. 2020;293:113463
• Cano-Valderrama O, Morales X, Ferrigni CJ, Martin-Antona E, Turrado V, Garcia A, Cunarro-Lopez Y, Zarain-Obrador L, Duran-Poveda M, Balibrea JM, Torres AJ. Reduction in emergency surgery activity during COVID-19 pandemic in three Spanish hospitals. Br J Surg. 2020;107(8):e239.
• Morello F, Bima P, Ferreri E, Chiarlo M, Balzaretti P, Gloria T, Petitti P, Apra F, Vallino D, Carbone G, Pivetta EE, Lupia E. After the first wave and beyond lockdown: long-lasting changes in emergency department visit number, characteristics, diagnoses, and hopital admissions. Intern Emerg Med. 2021;16(6):1683-90
• Carret ML, Fassa AC, Domingues MR. Inappropriate use of emergency services: a systematic review of prevalence and associated factors. Cad Saude Publica 2009;25(1):7-28.
• Oh HC, Chow WL, Gao Y, Tiah L, Goh SH, Mohan T. Factors associated with inappropriate attendances at the emergency department of a tertiary hospital in Singapore. Singapore Med J 2020;61(2):75-80.
• McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke, S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Medicine 2013;11:258.
• Bianco, A., Pileggi, C., & Angelillo, I. F. Non-urgent visits to a hospital emergency department in Italy. Public Health 2003;117(4):250-55.
• Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PloS One 2018 30;13(8):1-42.
• American College of Emergency Physicians. Crowding, https://www.acep.org/patient-care/policy-statements/crowding/ [Accessed September 25 2021].