Emergency visits by older adults decreased during <scp>COVID</scp>‐19 but increased in the oldest old

Uimonen, Mikko; Kuitunen, Ilari; Jämsen, Esa; Ponkilainen, Ville; Mattila, Ville M.

doi:10.1111/jgs.17143

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…It is also possible that existing vulnerabilities in the senior population were exacerbated during the pandemic. Such a trend has been observed in several studies that found a significant decrease in the senior population in the emergency department during epidemic waves [29,30].…”

Section: Seniors Where the Most Impactedsupporting

confidence: 68%

Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines

et al. 2023

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Background The pandemic has impacted both patients infected by the SARS-CoV-2 virus and patients who seek emergency assistance due to other health issues. Changes in emergency demands are expected to have occurred during the pandemic, the objective of this investigation is to characterize the changes in ambulance emergency demands during the first year of the COVID-19 pandemic in the Vaud State of Switzerland. The goal of this research is to identify the collateral effects of the COVID-19 pandemic on emergency demands. To do so, this study quantifies the differences in health issues, level of severity, and patients’ sociodemographic characteristics (age, location, gender) prior to and during the outbreak. Method This is a retrospective, descriptive and comparative statistical analysis of all ambulance emergency missions from 2018 to 2020 (n = 107,150) in the State of Vaud in Switzerland. Variables analyzed were the number of ambulance missions, patient age and gender, health issues, severity (NACA scores), number of non-transports, mission times and locations. Variables were compared between prepandemic and pandemic situations across years and months. Comparative analysis used bivariate analysis, χ2 test, Student’s t test, and Mann‒Whitney U test. Results The pandemic has had two major impacts on the population’s emergency demands. The first appears to be due to COVID-19, with an increase in respiratory distress cases that doubled in November 2020. The second relates to the implementation of lockdown and quarantine measures for the population and the closures of restaurants and bars. These might explain the decrease in both the number of traumas and intoxications, reaching more than 25% and 28%, respectively. An increase in prehospital emergency demands by the older population, which accounted for 53% of all demands in 2020, is measured. Conclusion Collateral effects occurred during 2020 and were not only due to the pandemic but also due to protective measures deployed relative to the population. This work suggests that more targeted reflections and interventions concerning the most vulnerable group, the population of people 65 and older, should be of high priority. Gaining generalizable knowledge from the COVID-19 pandemic in prehospital settings is critical for the management of future pandemics or other unexpected disasters.

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Section: Seniors Where the Most Impactedsupporting

confidence: 68%

Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines

et al. 2023

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“…In Finland, in 3 hospital examinations, ED visits for all reasons decreased by 16% between 2019 and 2020 (18). Studied from the same data, ED visits due to injuries decreased in the age groups 70-79 and 80-89, but not in the age group > 90 (19). rology, radiology, pediatrics, gynecology, and anesthesiology.…”

mentioning

confidence: 90%

The effect of COVID-19 lockdown on the incidence of emergency department visits due to injuries and the most typical fractures in 4 Finnish hospitals

Nygren

Kopra

Kröger

et al. 2022

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Background and purpose: COVID-19 lockdowns have affected personal mobility and behavior worldwide. This study compared the number of emergency department (ED) visits due to injuries and typical low-energy fractures in Finland during the COVID-19 lockdown period in spring 2020 to the reference period in 2019. Patients and methods: The data was collected retrospectively from the electronic patient records of 4 hospitals covering 1/5 of the Finnish population. We included the patients who were admitted to a hospital ED due to any injury during the lockdown period (March 18–May 31, 2020) and the reference period (March 18–May 31, 2019). We compared the differences between the average daily EDadmissions in the 2 years using the zero-inflated Poisson regression model. Results: The overall number of ED visits due to injuries decreased by 16% (mean 134/day vs. 113/day, 95% CI –18 to –13). The number of ED visits due to wrist fractures decreased among women aged over 50 years by 40% (CI –59 to –9). Among women, the number of ED visits due to ankle fractures decreased by 32% (CI –52 to –5). The number of ED visits due to fractures of the upper end of the humerusdecreased by 52% (CI –71 to –22) among women. The number of ED visits due to hip fractures increased by 2% (CI –16 to 24). Interpretation: Restrictions in personal mobility decreased the number of ED visits due to injuries during the pandemic. The effect can mainly be seen as a decreased number of the most typical low-energy fractures among women. In contrast, lockdown restrictions had no effect on the number of hip fractures.

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“…Our results confirm the general trend of a reduction in ED use during the pandemic compared with previous years, as has been observed in other studies. [18][19][20][21] Furthermore, this reduction was mainly found for people with neoplasms, formal caregivers, and ED visits characterized by a low level of emergency.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on emergency department visits among palliative home care recipients: a retrospective population-based cohort study in the Piedmont region, Italy

et al. 2022

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Background: Integrated palliative home care (IHPC) is delivered to patients with progressive end-stage diseases. During the COVID-19 pandemic, IHPC needed to provide high-quality home care services for patients who were treated at home, with the goal of avoiding unnecessary care, hospital admissions, and emergency department (ED) visits. This study aimed to compare the ED visits of IHPC recipients in a large Italian region before and during the first two waves of the COVID-19 pandemic and to find sociodemographic or clinical characteristics associated with changes in ED visits during the first two waves of COVID-19 pandemic, compared with the period before. Methods: Administrative databases were used to identify sociodemographic and clinical variables of IHPC recipients admitted before and during the pandemic. The obtained data were balanced by applying a propensity score. The average number of ED visits before and during the pandemic was calculated by using the Welch’s t test and stratified by all the variables. Results: Before and during the pandemic, 5155 and 3177 recipients were admitted to IHPC, respectively. These individuals were primarily affected by neoplasms. ED visits of IHPC recipients reduced from 1346 to 467 before and during the pandemic, respectively. A reduced mortality among IHCP patients who had at least one ED visit during the pandemic (8% during the pandemic versus 15% before the pandemic) was found. The average number of ED visits decreased during the pandemic [0.143, confidence interval (CI) = (0.128–0.158) versus 0.264, CI = (0.242–0.286) before the pandemic; p < 0.001] for all ages and IHPC duration classes. The presence of a formal caregiver led to a significant decrease in ED use. Medium and high emergency ED admissions showed no difference, whereas a decrease in low-level emergency ED admissions during the pandemic [1.27, CI = (1.194–1.345) versus 1.439, CI = (1.3–1.579) before the pandemic; p = 0.036] was found. Conclusion: ED visits among IHPC recipients were significantly decreased during the first two waves of the COVID-19 pandemic, especially in those individuals characterized by a low level of emergency. This did not result in an increase in mortality among IHPC recipients. These findings could inform the reorganization of home care services after the pandemic.

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Emergency visits by older adults decreased during COVID‐19 but increased in the oldest old

Cited by 3 publications

References 10 publications

Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines

Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines

The effect of COVID-19 lockdown on the incidence of emergency department visits due to injuries and the most typical fractures in 4 Finnish hospitals

Impact of COVID-19 on emergency department visits among palliative home care recipients: a retrospective population-based cohort study in the Piedmont region, Italy

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