Department of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Republic of Korea.
Department of Emergency Medicine, VHS Medical Center, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Feb 25;101(8):e29009. doi: 10.1097/MD.0000000000029009.
The purpose of analyzing changes in the use of emergency departments (EDs) was to better understand how to use ED resources efficiently during infectious disease outbreaks.Our study was a retrospective observational study. We analyzed the patterns of visits of adult and pediatric patients to separate EDs during 2020 coronavirus disease 2019 (COVID-19) outbreak to know the changes in the ED utilization. We collected the patient's demographics and time of visit, patients' acuity level at triage, cause of visit, transportation used, disposition, symptom to visit time, length of stay, and top 10 most common complaints. We compared pediatric and adult EDs before and after COVID-19.The total number of patients who visited the EDs was 197,152 over 3 years. During the COVID-19 outbreak in 2020, the number of visits decreased significantly, especially the number of pediatric patients. The number of ED visits decreased in correlation with a surge in the number of confirmed COVID patients. The proportion of severe cases in pediatric emergency department (PED) visits increased, but there was no difference in adult emergency department. The number of hospitalized PED patients increased, and the number of hospitalized adult emergency department patients decreased. However, both types of ED patients increased in intensive care unit hospitalizations, proportion of deaths, and use of ambulances. The proportion of trauma patients in the PED increased significantly (P < .001). The time from symptom onset to ED visit time was reduced for patients. The ED length of stay increased in adults, and decreased for pediatric patients.COVID-19 brought about many changes to ED utilization. A greater reduction in ED utilization occurred in pediatric patients compared to adult patients. Our study showed changes in the number and characteristics of patients visiting the ED during the COVID-19 period compared to 2018 and 2019.
分析急诊科(ED)使用变化的目的是更好地了解在传染病爆发期间如何有效地利用 ED 资源。
我们的研究是一项回顾性观察研究。我们分析了 2020 年冠状病毒病 2019(COVID-19)爆发期间成年和儿科患者分别到不同 ED 就诊的模式,以了解 ED 利用率的变化。我们收集了患者的人口统计学资料和就诊时间、分诊时的患者 acuity 级别、就诊原因、使用的交通工具、处置方式、症状就诊时间、住院时间以及前 10 位最常见的主诉。我们比较了 COVID-19 前后儿科和成人 ED。
3 年来,共有 197152 名患者到 ED 就诊。在 2020 年 COVID-19 爆发期间,就诊人数明显减少,尤其是儿科患者。ED 就诊人数的减少与确诊 COVID 患者人数的激增有关。儿科急诊就诊中严重病例的比例增加,但成人急诊无差异。儿科住院患者人数增加,成人住院患者人数减少。然而,两类 ED 患者在 ICU 住院、病死率和使用救护车方面均有所增加。儿科创伤患者的比例显著增加(P<0.001)。患者从症状出现到就诊的时间缩短。成人 ED 住院时间延长,而儿科患者则缩短。
COVID-19 给 ED 的利用带来了许多变化。与成年患者相比,儿科患者的 ED 利用率下降幅度更大。与 2018 年和 2019 年相比,我们的研究显示了 COVID-19 期间 ED 就诊患者数量和特征的变化。