The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department

Zaboli, Arian; Brigo, Francesco; Sibilio, Serena; Canelles, Massimiliano Fanni; Rella, Eleonora; Magnarelli, Gabriele; Pfeifer, Norbert; Turcato, Gianni

doi:10.1016/j.ienj.2022.101229

Cited by 8 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our ndings, some participants reported that if they had received a physical assessment from their GP, they may have been able to avoid going to the ED. A study carried out in Italy, which examined non-urgent admissions to the ED, revealed an increase in the access of non-urgent patients during the pandemic [24]. The researchers noted that this rise could be attributed to a decrease in visits to GP's, leading patients to choose to visit the ED instead of opting for a virtual consultation [24].…”

Section: Discussionmentioning

confidence: 99%

“…A study carried out in Italy, which examined non-urgent admissions to the ED, revealed an increase in the access of non-urgent patients during the pandemic [24]. The researchers noted that this rise could be attributed to a decrease in visits to GP's, leading patients to choose to visit the ED instead of opting for a virtual consultation [24]. Furthermore a study conducted in Spain, which investigated the effects of COVID-19 on the inappropriate use of the ED, they identi ed that the inappropriate use of the ED was a result of delays in patient care in the primary care settings and a growing lack of trust in the primary care [25].…”

Section: Discussionmentioning

confidence: 99%

“…Most of our participants were deemed appropriate referrals considering the complexity of their health conditions. Interestingly, older adults were not categorized as inappropriate users of the ED in these studies [24,25]. The Virtual assessments were noted to be very bene cial going forward monitoring patients with chronic conditions such as diabetes, therefore following on from the COVID-19 pandemic virtual health assessments may be the norm in managing certain chronic conditions but not for acute illnesses [26].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Community dwelling older adults experience of attending the Emergency Department during COVID-19: A qualitative study

Ryan,

Barry,

Fitzgerald

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: The COVID-19 pandemic resulted in a decrease in emergency department (ED) visits, particularly among older adults. The objective of this study is to explore the experiences of older adults attending the ED during COVID-19. Methods: The study utilised a qualitative descriptive approach as part of a larger mixed-methods study. Data were collected at five different ED’s in Ireland, which represented both urban and rural populations. The participants were all aged over 65. Semi-structured phone interviews were conducted 10 days after attending the ED and the interviews were audio-recorded. The interviews were transcribed and imported to NVivo software, and the data was analysed using reflexive thematic analysis. Results: 16 interviews were conducted with older adults over 65. Three themes emerged following thematic analysis (1) Complexity of decision making regarding the ED attendance (2) Quality and timeliness of care in the ED (3) Communication with and empathy towards healthcare staff in the ED. The COVID-19 pandemic had a significant impact on the decision-making process and pathway for older adults seeking emergency medical care. Despite the challenges, older adults reported a positive experience in the ED. This was attributed to improved conditions, including shorter triage waiting times and the implementation of COVID-19 protocols. Participants demonstrated resilience and expressed gratitude for the care they received. However, for some participants it was noted there was a reluctance to express any dissatisfaction or complain about the care they received while in the ED. The study also highlighted concerns regarding discharge information and follow-up care for the older adult. Conclusion: The findings demonstrate that ED healthcare providers provided quality and timely care to older adults in the ED during COVID-19. However, the need for clear communication and information sharing from healthcare providers on ED discharge and across transitions of care was highlighted as an area needing improvement.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Community dwelling older adults experience of attending the Emergency Department during COVID-19: A qualitative study

Ryan,

Barry,

Fitzgerald

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In these months, although certain measures were in place to mitigate COVID-19, regular clinical activity gradually normalised, explaining the lack of difference. Some studies, such as a study by Zaboli et al in 2022 in Italy, found a patient profile that went to the emergency department with less severity throughout 2021 when compared to before the pandemic [ 26 ]. Future studies should analyse whether, after the initial impact in 2020, an opposite phenomenon of overuse of the emergency department occurred later.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Inappropriate Use of the Emergency Department

et al. 2023

View full text Add to dashboard Cite

Inappropriate use of the emergency department (IEDU)—consisting of the unnecessary use of the resource by patients with no clinical need—is one of the leading causes of the loss of efficiency of the health system. Specific contexts modify routine clinical practice and usage patterns. This study aims to analyse the influence of COVID-19 on the IEDU and its causes. Methods: A retrospective, cross-sectional study conducted in the emergency department of a high-complexity hospital. The Hospital Emergency Suitability Protocol (HESP) was used to measure the prevalence of IEDU and its causes, comparing three pairs of periods: (1) March 2019 and 2020; (2) June 2019 and 2020; and (3) September 2019 and 2020. A bivariate analysis and multivariate logistic regression models, adjusted for confounding variables, were utilized. Results: In total, 822 emergency visits were included (137 per period). A total prevalence of IEDU of 14.1% was found. There was a significant decrease in IEDU in March 2020 (OR: 0.03), with a prevalence of 0.8%. No differences were found in the other periods. A mistrust in primary care was the leading cause of IEDU (65.1%). Conclusions: The impact of COVID-19 reduced the frequency of IEDU during the period of more significant population restrictions, with IEDU returning to previous levels in subsequent months. Targeted actions in the field of population education and an improvement in primary care are positioned as strategies that could mitigate its impact.

show abstract

“…The progressive increase in the number of requests for evaluation in hospitals' Emergency Departments (EDs) after the COVID-19 pandemic, given an ever-decreasing number of available healthcare resources, makes triage one of the most important components of the emergency medical system. 1,2 At present, internationally validated triage systems (e.g., the Manchester Triage System, the Emergency Severity Index, and the South African Triage Scale) that can be compared between different regions and nations remain rare. Although there are recommendations supporting the use of globally standardized triage systems, many European countries today have adopted autonomous systems created according to local needs.…”

Section: Introductionmentioning

confidence: 99%

Italian validation of the Manchester Triage System towards short-term mortality: a prospective observational study

et al. 2023

Self Cite

View full text Add to dashboard Cite

The study aimed to validate the Manchester Triage System in a hospital setting using data for short- and medium-term death rates. A prospective observational study was conducted at the Emergency Department of Merano Hospital for two years. The discriminatory ability of MTS was tested using AUROCs and contingency tables, reporting sensitivity and specificity levels for each study outcome. A total of 98,443 patients were enrolled, 237 of whom died within 72h; 422 patients died within seven days, and 1025 died within 30 days. The MTS demonstrated excellent discriminatory ability, reporting AUROC values of 0.890 for death within 72h, 0.853 for death within seven days, and 0.781 for death within 30 days. A sensitivity of 87.7% and a specificity of 79.4% were reported for death at 72h, while a sensitivity of 69.6% and a specificity of 79.8% were reported for death at 30 days. The MTS has proven to be a good triage system capable of accurately identifying patients who are at risk of death in the short or medium term.

show abstract

The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department

Cited by 8 publications

References 28 publications

Community dwelling older adults experience of attending the Emergency Department during COVID-19: A qualitative study

Community dwelling older adults experience of attending the Emergency Department during COVID-19: A qualitative study

Impact of the COVID-19 Pandemic on Inappropriate Use of the Emergency Department

Italian validation of the Manchester Triage System towards short-term mortality: a prospective observational study

Contact Info

Product

Resources

About