描述性分析：南非开普敦一个地区级急救中心的患者就诊量和病种构成在全国 COVID-19 封锁期间的变化。

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.

机构信息

Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Emergency centres, Mitchells Plain and Heideveld hospitals, Cape Town, South Africa.

出版信息

S Afr Med J. 2020 Oct 12;110(11):1113-1118.

PMID:33403989

Abstract

BACKGROUND

The global COVID-19 pandemic caused many countries to institute nationwide lockdowns to limit the spread of the disease.

OBJECTIVES

To describe the effect of the national COVID-19 lockdown in South Africa (SA) on the workload and case mix of patients presenting to a district-level emergency centre.

METHODS

The electronic patient tracking and registration database at Mitchells Plain Hospital, a district-level hospital in Cape Town, was retrospectively analysed. The 5-week lockdown period (27 March - 30 April 2020) was compared with a similar period immediately before the lockdown (21 February - 26 March). A comparison was also made with corresponding time periods during 2018 and 2019. Patient demographics, characteristics, diagnoses and disposition, as well as process times, were compared.

RESULTS

A total of 26 164 emergency centre visits were analysed (8 297 in 2020, 9 726 in 2019, 8 141 in 2018). There was a reduction of 15% in overall emergency centre visits from 2019 to 2020 (non-trauma 14%, trauma 20%). A 35% decrease was seen between the 2020 lockdown period and the 5-week period before lockdown (non-trauma 33%, trauma 43%), and the reduced number of visits stayed similar throughout the lockdown period. The median age increased by 5 years during the 2020 lockdown period, along with an 8% decrease in patients aged <12 years. High-acuity patients increased by 6% and the emergency centre mortality rate increased by 1%. All process times were shorter during the lockdown period (time to triage -24%, time to consultation -56%, time to disposition decision -29%, time in the emergency centre -20%).

CONCLUSIONS

The SA national COVID-19 lockdown resulted in a substantial decrease in the number of patients presenting to the emergency centre. It is yet to be seen how quickly emergency centre volumes will recover as lockdown measures are eased.

摘要

背景

全球 COVID-19 大流行导致许多国家实施全国封锁，以限制疾病传播。

目的

描述南非（SA）全国 COVID-19 封锁对到区一级急救中心就诊的患者工作量和病例组合的影响。

方法

对开普敦米切尔平原医院的电子患者跟踪和登记数据库进行回顾性分析。将封锁期（2020 年 3 月 27 日至 4 月 30 日）与封锁前的类似时期（2020 年 2 月 21 日至 26 日）进行比较。还与 2018 年和 2019 年同期进行了比较。比较了患者人口统计学特征、特征、诊断和处置以及处理时间。

结果

共分析了 26164 例急救中心就诊（2020 年 8297 例，2019 年 9726 例，2018 年 8141 例）。与 2019 年相比，急救中心就诊总人数减少了 15%（非创伤性 14%，创伤性 20%）。2020 年封锁期与封锁前 5 周相比下降了 35%（非创伤性 33%，创伤性 43%），就诊人数减少在整个封锁期间保持相似。中位年龄增加了 5 岁，年龄在 12 岁以下的患者减少了 8%。高急症患者增加了 6%，急诊中心死亡率增加了 1%。封锁期间所有处理时间都缩短了（分诊时间-24%，咨询时间-56%，处置决策时间-29%，急诊中心时间-20%）。