Almana Ranya S, Alharbi Abeer
Health Administration Department, Business Administration College, King Saud University, Riyadh 11451, Saudi Arabia.
Healthcare (Basel). 2022 Nov 1;10(11):2193. doi: 10.3390/healthcare10112193.
Objective: The COVID-19 pandemic impacted health systems and Emergency Departments (ED) services worldwide. This study attempts to assess the impact of COVID-19 on the performance of the emergency department during COVID-19 in three hospitals in Riyadh city, Saudi Arabia. Methods: Ada’a data was used for this retrospective cohort study. The hospitals included in this study were: a 300-bed maternity and children’s hospital; a 643-bed general hospital; and a 1230-bed tertiary hospital. All patients who visited the ED in the time period from September 2019 to December 2021 were included. The outcome variable was the Door to Disposition (DTD) which estimates the percentage of patients seen within 4 h from Door to Disposition. A two-way ANOVA test was used to examine the differences in the outcome variable by hospital and by the phase of COVID-19. Results: Both hospital and the phase of COVID-19 were significantly different in terms of the percentage of patients seen within four hours in the ED (DTD) (p-value < 0.05). On average, the DTD percentages dipped slightly in the early phase of COVID-19 (64.0% vs. 69.8%) and jumped sharply in the later phase (73.6%). Additionally, the average DTD score for the maternity and pediatric hospital (87.6%) was sharply higher than both general and tertiary hospitals (63.2%, and 56.5%, respectively). Conclusion: COVID-19 led to a significant drop in emergency department services performance in the early stage of the pandemic as patients spent more time at the ED. However, for the designated COVID-19 hospital, the ED performance improved as more patients spent less than 4 h at the ED in the early stages of COVID-19. This is a clear indication that careful planning and management of resources for ED services during a pandemic is effective.
新冠疫情对全球卫生系统和急诊科服务产生了影响。本研究旨在评估新冠疫情对沙特阿拉伯利雅得市三家医院急诊科在新冠疫情期间表现的影响。方法：本回顾性队列研究使用了阿达阿数据。本研究纳入的医院有：一家拥有300张床位的妇幼医院；一家拥有643张床位的综合医院；以及一家拥有1230张床位的三级医院。纳入了2019年9月至2021年12月期间前往急诊科就诊的所有患者。结局变量是从就诊到出院处置时间（DTD），该变量用于评估从就诊到出院处置在4小时内就诊患者的百分比。采用双向方差分析检验来考察医院和新冠疫情阶段在结局变量方面的差异。结果：在急诊科4小时内就诊患者的百分比（DTD）方面，医院和新冠疫情阶段均存在显著差异（p值<0.05）。平均而言，在新冠疫情早期，DTD百分比略有下降（64.0%对69.8%），而在后期大幅跃升（73.6%）。此外，妇幼医院的平均DTD得分（87.6%）明显高于综合医院和三级医院（分别为63.2%和56.5%）。结论：在疫情早期，新冠疫情导致急诊科服务表现显著下降，因为患者在急诊科停留的时间更长。然而，对于指定的新冠医院，在新冠疫情早期，随着更多患者在急诊科停留时间少于4小时，急诊科表现有所改善。这清楚地表明，在疫情期间对急诊科服务资源进行精心规划和管理是有效的。
