Tomaino Laura, Roncarati Ilaria, Rodríguez-Mireles Silvia, Rivas-Wagner Eva, López-Valcárcel Beatriz González, La Vecchia Carlo, Negri Eva, Di Maio Valerio, Contucci Susanna, Falsetti Lorenzo, Moroncini Gianluca, Serra-Majem Lluís
Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy.
Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Canary Health Service, Las Palmas de Gran Canaria, Spain.
Med Princ Pract. 2025 May 2:1-10. doi: 10.1159/000546166.
The aim of the study was to analyze the changes in the emergency department (ED) activity of two hospitals during the 2020 lockdown and corresponding timeframes in 2019 and 2021 to assess whether a more structured primary healthcare service could have influenced the COVID-19 pressure on the ED.
This is a multicenter, retrospective study on adult subjects registered to the selected ED during the timeframes considered. Patients <16 years old and women with obstetric or gynecological complaints were excluded. Study period was from 9 March to 3 May for the Italian ED (55 days) and March 14 to May 10 for the Spanish ED (57 days) in 2019, 2020, and 2021. Primary outcome includes difference in the number of ED admissions. Secondary outcomes consist of differences in hospital admission rates, priority code at triage, and disease group.
Overall, a greater number of patients flowed through the Spanish ED (14,034 vs. 8,569 in 2019, 7,208 vs. 3,101 in 2020, and 13,214 vs. 5,555 in 2021), with smaller proportional declines and lower admission rates (13% vs. 16.9% in 2019, 19.6% vs. 34.3% in 2020, and 14.3% vs. 26.3% in 2021) observed. Most referrals were for nonemergency conditions, followed by trauma and intoxications.
In comparison with the Italian setting, the Spanish ED showed increased activity alongside lower hospitalization rates. Further investigation is required to evaluate the potential role of more structured primary healthcare assistance in enhancing the discharge rate to homecare or primary healthcare facilities during the specified timeframes.
本研究旨在分析两家医院在2020年封锁期间以及2019年和2021年相应时间段内急诊科（ED）的活动变化，以评估更具结构化的初级医疗服务是否会对急诊科的新冠疫情压力产生影响。
这是一项多中心回顾性研究，研究对象为在所选时间段内在所选急诊科登记的成年患者。排除16岁以下患者以及有产科或妇科主诉的女性患者。2019年、2020年和2021年，意大利急诊科的研究时间段为3月9日至5月3日（55天），西班牙急诊科的研究时间段为3月14日至5月10日（57天）。主要结局包括急诊科入院人数的差异。次要结局包括住院率、分诊时的优先代码以及疾病组的差异。
总体而言，西班牙急诊科的就诊患者数量更多（2019年为14,034例对8,569例，2020年为7,208例对3,101例，2021年为13,214例对5,555例），观察到的比例下降幅度较小且住院率较低（2019年为13%对16.9%，2020年为19.6%对34.3%，2021年为14.3%对26.3%）。大多数转诊是针对非紧急情况，其次是创伤和中毒。
与意大利的情况相比，西班牙急诊科的活动增加，同时住院率较低。需要进一步调查，以评估在特定时间段内更具结构化的初级医疗援助在提高居家护理或初级医疗设施出院率方面的潜在作用。
