Department of Health Sciences (DISSAL), University of Genoa.
Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
J Prev Med Hyg. 2024 Aug 31;65(2):E154-E165. doi: 10.15167/2421-4248/jpmh2024.65.2.3279. eCollection 2024 Jun.
SARS-CoV-2 has changed the demand for in-person health care. The aim of this study was to retrospectively analyzed data on access to San Martino Hospital Emergency Department (ED), Genoa, Italy, during the COVID-19 pandemic.
Descriptive statistics for 180,117 records of patients accessing the ED between 2019 and 2021 were reported. A linear regression model was built to evaluate the relationship between the weekly number of COVID-like illness cases and ED attendances.
In comparison to pre-pandemic levels, the median number of ED visits declined by 41.6% in 2020 and by 27.4% in 2021. The period of maximum drop in access (-61.9%) was the 2020 12-16th calendar weeks and coincided with the highest rates of COVID-like illness cases (+360%; 22.8% of total ED attendances). About 20% of the variation of the weekly number of ED attendances was explained by the number of COVID-like illness cases. In 2020 and 2021 non-urgent ED codes decreased (-6.7%; -7.3%) and both urgent and emergency ED codes increased (+4.8% and +3.9% the first; +1.9% and +3.5% the second). However, the absolute number of ED access fell drastically for all codes. In particular, the highest increase was registered in 2020 for acute respiratory infections (ARI), including COVID-19 (+3.28%), while traumas and eye diseases saw the highest decrease (-1.02%; -3.80%).
While the reduction in non-urgent visits suggests avoidable pre-pandemic access levels, the decline in non-COVID-19 urgent accesses potentially points to an increase in delayed and missed care.
SARS-CoV-2 改变了人们对实体医疗的需求。本研究旨在回顾分析意大利热那亚圣马蒂诺医院急诊科（ED）在 COVID-19 大流行期间的就诊数据。
报告了 2019 年至 2021 年期间 180117 例 ED 就诊患者的数据的描述性统计。建立了线性回归模型来评估每周 COVID 样疾病病例数与 ED 就诊人数之间的关系。
与大流行前水平相比，2020 年 ED 就诊人数中位数下降了 41.6%，2021 年下降了 27.4%。就诊人数下降幅度最大的时期（-61.9%）为 2020 年 12 月至 16 周，与 COVID 样疾病病例数的最高增长率（+360%；占总 ED 就诊人数的 22.8%）相吻合。每周 ED 就诊人数的变化约有 20%可以由 COVID 样疾病病例数来解释。2020 年和 2021 年非紧急 ED 编码减少（-6.7%；-7.3%），紧急和急救 ED 编码均增加（第一个增加了+4.8%和+3.9%；第二个增加了+1.9%和+3.5%）。然而，所有编码的 ED 就诊人数都大幅下降。特别是，2020 年急性呼吸道感染（ARI），包括 COVID-19，就诊人数增加最多（+3.28%），而创伤和眼病就诊人数下降最多（-1.02%；-3.80%）。
虽然非紧急就诊人数的减少表明大流行前存在可避免的就诊水平，但非 COVID-19 紧急就诊人数的下降可能表明延迟和错过治疗的情况增加。
