Patterns of Emergency Department visits for acute and chronic diseases during the two pandemic waves in Italy.
Acute Disease
Adolescent
Adult
Aged
COVID-19
/ epidemiology
Child
Child, Preschool
Chronic Disease
Cross-Sectional Studies
Emergency Service, Hospital
/ statistics & numerical data
Facilities and Services Utilization
Female
Hospitalization
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Italy
/ epidemiology
Male
Middle Aged
Retrospective Studies
Young Adult
Acute diseases
COVID-19
Chronic diseases
ED visits
Emergency departments
Pandemic
Journal
The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
02
04
2021
revised:
28
06
2021
accepted:
01
07
2021
pubmed:
17
7
2021
medline:
18
12
2021
entrez:
16
7
2021
Statut:
ppublish
Résumé
Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases. We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models. We found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure. The two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.
Sections du résumé
BACKGROUND
Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases.
METHODS
We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models.
MAIN FINDINGS
We found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure.
CONCLUSIONS
The two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.
Identifiants
pubmed: 34271231
pii: S0735-6757(21)00572-6
doi: 10.1016/j.ajem.2021.07.010
pmc: PMC9758955
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
22-26Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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