Neubauer Jonas, Richter Paul, Strudel Lisa, Ziemssen Focke, Dimopoulos Spyridon
Center of Ophthalmology, Eberhard-Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany.
Center of Ophthalmology, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany.
J Clin Med. 2024 Oct 7;13(19):5962. doi: 10.3390/jcm13195962.
The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, including the delivery of ophthalmic emergency services. This study examines the impact of the COVID-19 pandemic on the clinical presentation of emergencies and the accessibility of healthcare in ophthalmology. The study employed a single-center, consecutive case series design with historical controls to examine electronic health records over a 21-day period during the COVID-19 pandemic and a matched period from the preceding year. Records were analyzed for demographic variables, diagnosis, length of stay, travel distance, and referral status. The urgency of cases was evaluated by three independent graders using the BaSe SCOrE (BAsic SEverity Score for Common OculaR Emergencies). A total of 1229 patients were included in the study, with 786 patients in the 2019 cohort and 443 patients in the 2020 cohort. During the pandemic period, there was a significant decrease in the number of patients and the duration of their visits ( < 0.0001, < 0.0001, respectively). There was an increase in walk-in patients ( = 0.03), who took significantly longer journeys to be treated as compared to referred patients ( < 0.01). At the same time, the severity of emergencies increased ( = 0.02). The 2019 logistic regression model found that age ( = 0.003), referral status ( < 0.001), distance ( = 0.009), and first presentation ( = 0.02) were significant predictors of the severity, while gender was not ( = 0.78). The 2020 model found that only age ( < 0.001) and referral status ( < 0.001) were significant predictors of severity. The observed decline in patient volume, increased severity of emergencies, and shifts in predictive variables within the logistic regression models are indicative of significant barriers to healthcare access. Therefore, enhancing health literacy and ensuring low-threshold access to emergency services are crucial, especially during crises.
新冠疫情对全球医疗系统产生了深远影响，包括眼科急诊服务的提供。本研究探讨了新冠疫情对眼科急诊临床表现及医疗可及性的影响。该研究采用单中心、连续病例系列设计并设置历史对照，以审查新冠疫情期间21天内的电子健康记录以及上一年同期匹配时间段的记录。分析记录中的人口统计学变量、诊断、住院时间、就诊距离和转诊状态。由三名独立评分者使用BaSe SCOrE（常见眼科急诊基本严重程度评分）评估病例的紧急程度。该研究共纳入1229例患者，2019年队列有786例患者，2020年队列有443例患者。在疫情期间，患者数量及其就诊时长均显著减少（分别为P<0.0001，P<0.0001）。自行前来就诊的患者数量增加（P = 0.03），与转诊患者相比，他们前来接受治疗的路程显著更长（P<0.01）。与此同时，急诊的严重程度增加（P = 0.02）。2019年的逻辑回归模型发现，年龄（P = 0.003）、转诊状态（P<0.001）、距离（P = 0.009）和首次就诊（P = 0.02）是严重程度的显著预测因素，而性别不是（P = 0.78）。2020年的模型发现，只有年龄（P<0.001）和转诊状态（P<0.001）是严重程度的显著预测因素。观察到的患者数量下降、急诊严重程度增加以及逻辑回归模型中预测变量的变化表明医疗可及性存在重大障碍。因此，提高健康素养并确保急诊服务的低门槛可及性至关重要，尤其是在危机期间。
