Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak

The immediate and long-term impact of severe acute respiratory syndrome (SARS) outbreak on emergency department (ED) visits and hospital expenditures for these visits has not been thoroughly investigated. The objectives of this retrospective observational study investigated the impact of SARS outbre...

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Main Authors: Hsien-Hao Huang, David Hung-Tsang Yen, Wei-Fong Kao, Lee-Min Wang, Chun-I Huang, Chen-Hsen Lee
Format: Article
Language:English
Published: Elsevier 2006-01-01
Series:Journal of the Formosan Medical Association
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664609601066
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author Hsien-Hao Huang
David Hung-Tsang Yen
Wei-Fong Kao
Lee-Min Wang
Chun-I Huang
Chen-Hsen Lee
author_facet Hsien-Hao Huang
David Hung-Tsang Yen
Wei-Fong Kao
Lee-Min Wang
Chun-I Huang
Chen-Hsen Lee
author_sort Hsien-Hao Huang
collection DOAJ
description The immediate and long-term impact of severe acute respiratory syndrome (SARS) outbreak on emergency department (ED) visits and hospital expenditures for these visits has not been thoroughly investigated. The objectives of this retrospective observational study investigated the impact of SARS outbreak on ED visits and the cost of these visits in a designated SARS medical center. Methods: Data related to the total number of ED visits and their costs were collected for the SARS epidemic period in 2003 and the same period in the preceding year in 2002. Data collected included total number of ED visits, services provided, triage categories, and total expenditures for all patients. Data for before and during the outbreak were retrieved and compared. Results: At the peak of the SARS epidemic, the reduction in daily ED visits reached 51.6% of pre-epidemic numbers (p < 0.01). In pediatric, trauma and non-trauma patients, the maximum mean decreases in number of visits were 80.0% (p < 0.01), 57.6% (p < 0.01) and 40.8% (p < 0.01), respectively. In triage 1, 2 and 3 patients, the maximum mean decreases were 18.1% (p < 0.01), 55.9% (p < 0.01) and 53.7% (p < 0.01), respectively. The maximum decrease in total costs was 37.7% (p < 0.01). The maximum mean costs per patient increased 35.9% (p < 0.01). The proportions of increases in mean costs for each patient were attributed to laboratory investigations (31.4%), radiography (21.9%) and medications (29.5%). Conclusion: The SARS outbreak resulted in a marked reduction in the number of ED visits which persisted for 3 months after the end of the epidemic. Total cost of treating individual patients showed a simultaneous marked increase, while overall operational costs in the ED showed a marked decrease. The increased total cost for each patient was attributed to the increased number of diagnostic procedures to screen for possible SARS in the ED.
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spelling doaj.art-a84c13464c234584828d8d3bed7c1c112022-12-22T00:31:17ZengElsevierJournal of the Formosan Medical Association0929-66462006-01-011051313710.1016/S0929-6646(09)60106-6Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) OutbreakHsien-Hao Huang0David Hung-Tsang Yen1Wei-Fong Kao2Lee-Min Wang3Chun-I Huang4Chen-Hsen Lee5Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.Department of Emergency Medicine, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.The immediate and long-term impact of severe acute respiratory syndrome (SARS) outbreak on emergency department (ED) visits and hospital expenditures for these visits has not been thoroughly investigated. The objectives of this retrospective observational study investigated the impact of SARS outbreak on ED visits and the cost of these visits in a designated SARS medical center. Methods: Data related to the total number of ED visits and their costs were collected for the SARS epidemic period in 2003 and the same period in the preceding year in 2002. Data collected included total number of ED visits, services provided, triage categories, and total expenditures for all patients. Data for before and during the outbreak were retrieved and compared. Results: At the peak of the SARS epidemic, the reduction in daily ED visits reached 51.6% of pre-epidemic numbers (p < 0.01). In pediatric, trauma and non-trauma patients, the maximum mean decreases in number of visits were 80.0% (p < 0.01), 57.6% (p < 0.01) and 40.8% (p < 0.01), respectively. In triage 1, 2 and 3 patients, the maximum mean decreases were 18.1% (p < 0.01), 55.9% (p < 0.01) and 53.7% (p < 0.01), respectively. The maximum decrease in total costs was 37.7% (p < 0.01). The maximum mean costs per patient increased 35.9% (p < 0.01). The proportions of increases in mean costs for each patient were attributed to laboratory investigations (31.4%), radiography (21.9%) and medications (29.5%). Conclusion: The SARS outbreak resulted in a marked reduction in the number of ED visits which persisted for 3 months after the end of the epidemic. Total cost of treating individual patients showed a simultaneous marked increase, while overall operational costs in the ED showed a marked decrease. The increased total cost for each patient was attributed to the increased number of diagnostic procedures to screen for possible SARS in the ED.http://www.sciencedirect.com/science/article/pii/S0929664609601066costemergency department (ED)epidemiologysevere acute respiratory syndrome (SARS)
spellingShingle Hsien-Hao Huang
David Hung-Tsang Yen
Wei-Fong Kao
Lee-Min Wang
Chun-I Huang
Chen-Hsen Lee
Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
Journal of the Formosan Medical Association
cost
emergency department (ED)
epidemiology
severe acute respiratory syndrome (SARS)
title Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
title_full Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
title_fullStr Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
title_full_unstemmed Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
title_short Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak
title_sort declining emergency department visits and costs during the severe acute respiratory syndrome sars outbreak
topic cost
emergency department (ED)
epidemiology
severe acute respiratory syndrome (SARS)
url http://www.sciencedirect.com/science/article/pii/S0929664609601066
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