Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel.
Creighton University School of Medicine, Omaha, Nebraska, United States of America.
PLoS One. 2024 Oct 1;19(10):e0299608. doi: 10.1371/journal.pone.0299608. eCollection 2024.
The COVID-19 pandemic has claimed over one million lives in the United States and has drastically changed how patients interact with the healthcare system. Emergency medical services (EMS) are essential for emergency response, disaster preparedness, and responding to everyday emergencies. We therefore examined differences in EMS utilization and call severity in 2020 compared to trends from 2015-2019 in a large, multi-state advanced life support EMS agency serving the U.S. Upper Midwest. Specifically, we analyzed all emergency calls made to Mayo Clinic Ambulance, the sole advanced life support EMS provider serving a large area in Minnesota and Wisconsin, and compared the number of emergency calls made in 2020 to the number of calls expected based on trends from 2015-2019. We similarly compared caller demographics, call severity, and proportions of calls made for overdose/intoxication, behavioral health, and motor vehicle accidents. Subgroup analyses were performed for rural vs. urban areas. We identified 262,232 emergent EMS calls during 2015-2019 and 53,909 calls in 2020, corresponding to a decrease of 28.7% in call volume during 2020. Caller demographics shifted slightly towards older patients (mean age 59.7 [SD, 23.0] vs. 59.1 [SD, 23.7] years; p<0.001) and to rural areas (20.4% vs. 20.0%; p = 0.007). Call severity increased, with 95.3% of calls requiring transport (vs. 93.8%; p<0.001) and 1.9% resulting in death (vs. 1.6%; p<0.001). The proportion of calls for overdose/intoxication increased from 4.8% to 5.5% (p<0.001), while the proportion of calls for motor vehicle collisions decreased from 3.9% to 3.0% (p<0.001). All changes were more pronounced in urban areas. These findings underscore the extent to which the COVID-19 pandemic impacted healthcare utilization, particularly in urban areas, and suggest that patients may have delayed calling EMS with potential implications on disease severity and risk of death.
新冠疫情已导致美国超过 100 万人死亡，并极大地改变了患者与医疗系统的互动方式。紧急医疗服务（EMS）对于应急响应、灾难准备和应对日常紧急情况至关重要。因此，我们研究了美国上中西部一个大型多州高级生命支持 EMS 机构 2020 年与 2015-2019 年趋势相比 EMS 使用情况和呼叫严重程度的差异。具体来说，我们分析了向梅奥诊所救护车（明尼苏达州和威斯康星州一个大地区唯一的高级生命支持 EMS 提供商）拨打的所有紧急电话，并将 2020 年的紧急电话数量与 2015-2019 年趋势预测的电话数量进行了比较。我们还比较了呼叫者人口统计学特征、呼叫严重程度以及过量/中毒、行为健康和机动车事故呼叫的比例。对于农村和城市地区，我们进行了亚组分析。我们在 2015-2019 年期间确定了 262232 个紧急 EMS 呼叫，在 2020 年期间确定了 53909 个呼叫，这表明 2020 年呼叫量下降了 28.7%。呼叫者人口统计学特征略有向老年患者（平均年龄 59.7 [SD，23.0] 岁与 59.1 [SD，23.7] 岁；p<0.001）和农村地区（20.4% 与 20.0%；p = 0.007）转移。呼叫严重程度增加，需要转运的呼叫占 95.3%（93.8%；p<0.001），1.9%导致死亡（1.6%；p<0.001）。过量/中毒呼叫的比例从 4.8%增加到 5.5%（p<0.001），而机动车碰撞呼叫的比例从 3.9%减少到 3.0%（p<0.001）。这些变化在城市地区更为明显。这些发现强调了新冠疫情对医疗保健利用的影响程度，尤其是在城市地区，并表明患者可能延迟拨打 EMS 电话，这可能对疾病严重程度和死亡风险产生影响。
