First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands
During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW,...
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| Veröffentlicht in: | PloS one 2023-02, Vol.18 (2), p.e0279105-e0279105 |
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| creator | Dijk, Robi Plaum, Patricia Tummers, Stan van Osch, Frits H M Barten, Dennis G Latten, Gideon H P |
| description | During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW, compared to 2019 reference periods.
We performed a retrospective analysis of ED utilization in 3 Dutch hospitals in 2020. The FW and SW (March-June and September-December, respectively) were compared to the reference periods in 2019. ED visits were labeled as (non-)COVID-suspected.
During the FW and SW ED visits decreased by 20.3% and 15.3%, respectively, when compared to reference periods in 2019. During both waves high urgency visits significantly increased with 3.1% and 2.1%, and admission rates (ARs) increased with 5.0% and 10.4%. Trauma related visits decreased by 5.2% and 3.4%. During the SW we observed less COVID-related visits compared to the FW (4,407 vs 3,102 patients). COVID-related visits were significantly more often in higher need of urgent care and ARs were at least 24.0% higher compared to non-COVID visits.
During both COVID-19 waves, ED visits were significantly reduced. ED patients were more often triaged as high urgent, the ED length of stay was longer and ARs were increased compared to the reference period in 2019, reflecting a high burden on ED resources. During the FW, the reduction in ED visits was most pronounced. Here, ARs were also higher and patient were more often triaged as high urgency. These findings stress the need to gain better insight into the motives of patients to delay or avoid emergency care during pandemics, as well as to better prepare EDs for future outbreaks. |
| doi_str_mv | 10.1371/journal.pone.0279105 |
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We performed a retrospective analysis of ED utilization in 3 Dutch hospitals in 2020. The FW and SW (March-June and September-December, respectively) were compared to the reference periods in 2019. ED visits were labeled as (non-)COVID-suspected.
During the FW and SW ED visits decreased by 20.3% and 15.3%, respectively, when compared to reference periods in 2019. During both waves high urgency visits significantly increased with 3.1% and 2.1%, and admission rates (ARs) increased with 5.0% and 10.4%. Trauma related visits decreased by 5.2% and 3.4%. During the SW we observed less COVID-related visits compared to the FW (4,407 vs 3,102 patients). COVID-related visits were significantly more often in higher need of urgent care and ARs were at least 24.0% higher compared to non-COVID visits.
During both COVID-19 waves, ED visits were significantly reduced. ED patients were more often triaged as high urgent, the ED length of stay was longer and ARs were increased compared to the reference period in 2019, reflecting a high burden on ED resources. During the FW, the reduction in ED visits was most pronounced. Here, ARs were also higher and patient were more often triaged as high urgency. These findings stress the need to gain better insight into the motives of patients to delay or avoid emergency care during pandemics, as well as to better prepare EDs for future outbreaks.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0279105</identifier><identifier>PMID: 36795702</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>COVID-19 ; COVID-19 - epidemiology ; Emergencies ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital ; Engineering and Technology ; Hospitals ; Humans ; Infections ; Length of stay ; Medicine and Health Sciences ; Netherlands - epidemiology ; Observational studies ; Pandemics ; Patients ; Retrospective Studies ; Severe acute respiratory syndrome coronavirus 2 ; Trauma ; Utilization</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0279105-e0279105</ispartof><rights>Copyright: © 2023 Dijk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>2023 Dijk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Dijk et al 2023 Dijk et al</rights><rights>2023 Dijk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-1170324e7818fbe480be1917bbe4a0a84d77933912ff52327ba30eac7353dc703</citedby><cites>FETCH-LOGICAL-c526t-1170324e7818fbe480be1917bbe4a0a84d77933912ff52327ba30eac7353dc703</cites><orcidid>0000-0002-7185-9491 ; 0000-0002-4110-5242 ; 0000-0003-4329-2560</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934309/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934309/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36795702$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Kuo, Yong-Hong</contributor><creatorcontrib>Dijk, Robi</creatorcontrib><creatorcontrib>Plaum, Patricia</creatorcontrib><creatorcontrib>Tummers, Stan</creatorcontrib><creatorcontrib>van Osch, Frits H M</creatorcontrib><creatorcontrib>Barten, Dennis G</creatorcontrib><creatorcontrib>Latten, Gideon H P</creatorcontrib><title>First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW, compared to 2019 reference periods.
We performed a retrospective analysis of ED utilization in 3 Dutch hospitals in 2020. The FW and SW (March-June and September-December, respectively) were compared to the reference periods in 2019. ED visits were labeled as (non-)COVID-suspected.
During the FW and SW ED visits decreased by 20.3% and 15.3%, respectively, when compared to reference periods in 2019. During both waves high urgency visits significantly increased with 3.1% and 2.1%, and admission rates (ARs) increased with 5.0% and 10.4%. Trauma related visits decreased by 5.2% and 3.4%. During the SW we observed less COVID-related visits compared to the FW (4,407 vs 3,102 patients). COVID-related visits were significantly more often in higher need of urgent care and ARs were at least 24.0% higher compared to non-COVID visits.
During both COVID-19 waves, ED visits were significantly reduced. ED patients were more often triaged as high urgent, the ED length of stay was longer and ARs were increased compared to the reference period in 2019, reflecting a high burden on ED resources. During the FW, the reduction in ED visits was most pronounced. Here, ARs were also higher and patient were more often triaged as high urgency. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dijk, Robi</au><au>Plaum, Patricia</au><au>Tummers, Stan</au><au>van Osch, Frits H M</au><au>Barten, Dennis G</au><au>Latten, Gideon H P</au><au>Kuo, Yong-Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-16</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0279105</spage><epage>e0279105</epage><pages>e0279105-e0279105</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW, compared to 2019 reference periods.
We performed a retrospective analysis of ED utilization in 3 Dutch hospitals in 2020. The FW and SW (March-June and September-December, respectively) were compared to the reference periods in 2019. ED visits were labeled as (non-)COVID-suspected.
During the FW and SW ED visits decreased by 20.3% and 15.3%, respectively, when compared to reference periods in 2019. During both waves high urgency visits significantly increased with 3.1% and 2.1%, and admission rates (ARs) increased with 5.0% and 10.4%. Trauma related visits decreased by 5.2% and 3.4%. During the SW we observed less COVID-related visits compared to the FW (4,407 vs 3,102 patients). COVID-related visits were significantly more often in higher need of urgent care and ARs were at least 24.0% higher compared to non-COVID visits.
During both COVID-19 waves, ED visits were significantly reduced. ED patients were more often triaged as high urgent, the ED length of stay was longer and ARs were increased compared to the reference period in 2019, reflecting a high burden on ED resources. During the FW, the reduction in ED visits was most pronounced. Here, ARs were also higher and patient were more often triaged as high urgency. These findings stress the need to gain better insight into the motives of patients to delay or avoid emergency care during pandemics, as well as to better prepare EDs for future outbreaks.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36795702</pmid><doi>10.1371/journal.pone.0279105</doi><orcidid>https://orcid.org/0000-0002-7185-9491</orcidid><orcidid>https://orcid.org/0000-0002-4110-5242</orcidid><orcidid>https://orcid.org/0000-0003-4329-2560</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | COVID-19 COVID-19 - epidemiology Emergencies Emergency medical care Emergency medical services Emergency Service, Hospital Engineering and Technology Hospitals Humans Infections Length of stay Medicine and Health Sciences Netherlands - epidemiology Observational studies Pandemics Patients Retrospective Studies Severe acute respiratory syndrome coronavirus 2 Trauma Utilization |
| title | First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands |
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