دورية أكاديمية
An Analysis of Changes in Emergency Department Visits After a State Declaration During the Time of COVID-19.
| العنوان: | An Analysis of Changes in Emergency Department Visits After a State Declaration During the Time of COVID-19. |
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| المؤلفون: | Westgard BC; Department of Emergency Medicine, Regions Hospital, St. Paul, MN; Health Partners Institute, Bloomington, MN. Electronic address: bjorn.c.westgard@healthpartners.com., Morgan MW; Department of Emergency Medicine, Regions Hospital, St. Paul, MN., Vazquez-Benitez G; Health Partners Institute, Bloomington, MN., Erickson LO; Health Partners Institute, Bloomington, MN., Zwank MD; Department of Emergency Medicine, Regions Hospital, St. Paul, MN. |
| المصدر: | Annals of emergency medicine [Ann Emerg Med] 2020 Nov; Vol. 76 (5), pp. 595-601. Date of Electronic Publication: 2020 Jun 11. |
| نوع المنشور: | Comparative Study; Journal Article; Observational Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 8002646 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6760 (Electronic) Linking ISSN: 01960644 NLM ISO Abbreviation: Ann Emerg Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: [Lansing, Mich., American College of Emergency Physicians] |
| مواضيع طبية MeSH: | Betacoronavirus* , Pandemics*, Coronavirus Infections/*epidemiology , Emergencies/*epidemiology , Emergency Service, Hospital/*statistics & numerical data , Patient Acceptance of Health Care/*statistics & numerical data , Pneumonia, Viral/*epidemiology, Adult ; COVID-19 ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; SARS-CoV-2 ; United States/epidemiology |
| مستخلص: | Study Objective: In the initial period of the coronavirus disease 2019 (COVID-19) pandemic, there has been a substantial decrease in the number of patients seeking care in the emergency department. A first step in estimating the impact of these changes is to characterize the patients, visits, and diagnoses for whom care is being delayed or deferred. Methods: We conducted an observational study, examining demographics, visit characteristics, and diagnoses for all ED patient visits to an urban level 1 trauma center before and after a state emergency declaration and comparing them with a similar period in 2019. We estimated percent change on the basis of the ratios of before and after periods with respect to 2019 and the decline per week using Poisson regression. Finally, we evaluated whether each factor modified the change in overall ED visits. Results: After the state declaration, there was a 49.3% decline in ED visits overall, 35.2% (95% confidence interval -38.4 to -31.9) as compared with 2019. Disproportionate declines were seen in visits by pediatric and older patients, women, and Medicare recipients, as well as for presentations of syncope, cerebrovascular accidents, urolithiasis, and abdominal and back pain. Significant proportional increases were seen in ED visits for upper respiratory infections, shortness of breath, and chest pain. Conclusion: There have been significant changes in patterns of care seeking during the COVID-19 pandemic. Declines in ED visits, especially for certain demographic groups and disease processes, should prompt efforts to understand these phenomena, encourage appropriate care seeking, and monitor for the morbidity and mortality that may result from delayed or deferred care. (Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.) |
| References: | J Formos Med Assoc. 2009 May;108(5):386-94. (PMID: 19443292) Int J Tuberc Lung Dis. 2020 May 1;24(5):547-548. (PMID: 32398214) Sci Adv. 2020 Nov 4;6(45):. (PMID: 33148655) Lancet. 2020 May 2;395(10234):e81. (PMID: 32333839) J Am Coll Cardiol. 2020 Jun 9;75(22):2871-2872. (PMID: 32283124) N Engl J Med. 2020 Jun 11;382(24):2368-2371. (PMID: 32302076) Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631. (PMID: 32182131) |
| تواريخ الأحداث: | Date Created: 20201003 Date Completed: 20201103 Latest Revision: 20240329 |
| رمز التحديث: | 20240329 |
| مُعرف محوري في PubMed: | PMC7287464 |
| DOI: | 10.1016/j.annemergmed.2020.06.019 |
| PMID: | 33008651 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6760 |
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| DOI: | 10.1016/j.annemergmed.2020.06.019 |