Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital
AIMS OF THE STUDY While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2020-08-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2849 |
| _version_ | 1797974812261351424 |
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| author | Wolf E. Hautz Thomas C. Sauter Aristomenis K. Exadaktylos Gert Krummrey Stefan Schauber Martin Müller |
| author_facet | Wolf E. Hautz Thomas C. Sauter Aristomenis K. Exadaktylos Gert Krummrey Stefan Schauber Martin Müller |
| author_sort | Wolf E. Hautz |
| collection | DOAJ |
| description |
AIMS OF THE STUDY
While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.
METHODS
Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group.
RESULTS
In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared to the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp.
CONCLUSIONS
Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients.
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| first_indexed | 2024-04-11T04:25:38Z |
| format | Article |
| id | doaj.art-0fd0220ef6694de28cde37cc3e35892d |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T04:25:38Z |
| publishDate | 2020-08-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-0fd0220ef6694de28cde37cc3e35892d2022-12-29T16:02:35ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972020-08-01150333410.4414/smw.2020.20331Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospitalWolf E. Hautz0Thomas C. Sauter1Aristomenis K. Exadaktylos2Gert Krummrey3Stefan Schauber4Martin Müller5Department of Emergency Medicine, Inselspital, University Hospital Bern, SwitzerlandDepartment of Emergency Medicine, Inselspital, University Hospital Bern, SwitzerlandDepartment of Emergency Medicine, Inselspital, University Hospital Bern, SwitzerlandDepartment of Emergency Medicine, Inselspital, University Hospital Bern, SwitzerlandFaculty of Medicine, University of Oslo, NorwayDepartment of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland AIMS OF THE STUDY While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER. METHODS Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group. RESULTS In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared to the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp. CONCLUSIONS Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients. https://www.smw.ch/index.php/smw/article/view/2849COVID-19pandemicspneumonia/infectionsemergency care systemsemergency department utilisation |
| spellingShingle | Wolf E. Hautz Thomas C. Sauter Aristomenis K. Exadaktylos Gert Krummrey Stefan Schauber Martin Müller Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital Swiss Medical Weekly COVID-19 pandemics pneumonia/infections emergency care systems emergency department utilisation |
| title | Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital |
| title_full | Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital |
| title_fullStr | Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital |
| title_full_unstemmed | Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital |
| title_short | Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital |
| title_sort | barriers to seeking emergency care during the covid 19 pandemic may lead to higher morbidity and mortality a retrospective study from a swiss university hospital |
| topic | COVID-19 pandemics pneumonia/infections emergency care systems emergency department utilisation |
| url | https://www.smw.ch/index.php/smw/article/view/2849 |
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