tetano
Editor, Senior Moderator
Panminerva Med
. 2020 Jun 16.
doi: 10.23736/S0031-0808.20.04000-8. Online ahead of print.
Pattern of Emergency Department Referral During the Covid-19 Outbreak in Italy
Mattia Bellan[SUP] 1 2 3 [/SUP], Francesco Gavelli[SUP] 4 5 [/SUP], Eyal Hayden[SUP] 4 5 [/SUP], Filippo Patrucco[SUP] 4 [/SUP], Daniele Soddu[SUP] 4 5 [/SUP], Anita R Pedrinelli[SUP] 4 5 [/SUP], Micol G Cittone[SUP] 4 5 [/SUP], Eleonora Rizzi[SUP] 4 5 [/SUP], Giuseppe F Casciaro[SUP] 4 5 [/SUP], Veronica Vassia[SUP] 4 5 [/SUP], Raffaella Landi[SUP] 4 5 [/SUP], Mirta Menegatti[SUP] 5 [/SUP], Maria L Gastaldello[SUP] 4 5 [/SUP], Michela Beltrame[SUP] 4 5 [/SUP], Emanuela Labella[SUP] 4 5 [/SUP], Stelvio Tonello[SUP] 4 [/SUP], Gian C Avanzi[SUP] 4 5 [/SUP], Mario Pirisi[SUP] 4 5 [/SUP], Luigi M Castello[SUP] 4 5 [/SUP], Pier P Sainaghi[SUP] 4 6 5 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease (COVID-19) outbreak is putting the European National Health Systems under pressure. Interestingly, Emergency Department (ED) referrals for reasons other than Covid-19 seem to have declined steeply. In the present paper, we aimed to verify how the Covid-19 outbreak changed ED referral pattern.
Methods: We retrospectively reviewed the clinical records of patients referred to the ED of a University Hospital in Northern Italy from 1st March to 13th April 2020. We compared the following data with those belonging to the same period in 2019: number of EDs accesses, rate of hospital admission, frequencies of the most common causes of ED referral, priority codes of access.
Results: The number of ED referrals during the Covid-19 outbreak was markedly reduced when compared to the same period in 2019 (3059 vs. 5691;-46.3%). Conversely, the rate of hospital admission raised from 16.9% to 35.4% (p<0.0001), with a shift toward higher priority codes of ED admission. In 2020, we observed both a reduction of the number of patients referred for both traumatic (513, 16.8% vs. 1544, 27.1%; χ2=118.7, p<0.0001) and non-traumatic (4147 vs. 2546) conditions. Among the latter, suspected Covid-19 accounted for 1101 (43.2%) accesses.
Conclusions: The Covid-19 pandemic completely changed the pattern of ED referral in Italy, with a marked reduction of the accesses to the hospitals. This could be related to a limited exposure to traumas and to a common fear of being infected during EDs in-stay. This may limit the misuse of EDs for non- urgent conditions, but may also delay proper referrals for urgent conditions.
. 2020 Jun 16.
doi: 10.23736/S0031-0808.20.04000-8. Online ahead of print.
Pattern of Emergency Department Referral During the Covid-19 Outbreak in Italy
Mattia Bellan[SUP] 1 2 3 [/SUP], Francesco Gavelli[SUP] 4 5 [/SUP], Eyal Hayden[SUP] 4 5 [/SUP], Filippo Patrucco[SUP] 4 [/SUP], Daniele Soddu[SUP] 4 5 [/SUP], Anita R Pedrinelli[SUP] 4 5 [/SUP], Micol G Cittone[SUP] 4 5 [/SUP], Eleonora Rizzi[SUP] 4 5 [/SUP], Giuseppe F Casciaro[SUP] 4 5 [/SUP], Veronica Vassia[SUP] 4 5 [/SUP], Raffaella Landi[SUP] 4 5 [/SUP], Mirta Menegatti[SUP] 5 [/SUP], Maria L Gastaldello[SUP] 4 5 [/SUP], Michela Beltrame[SUP] 4 5 [/SUP], Emanuela Labella[SUP] 4 5 [/SUP], Stelvio Tonello[SUP] 4 [/SUP], Gian C Avanzi[SUP] 4 5 [/SUP], Mario Pirisi[SUP] 4 5 [/SUP], Luigi M Castello[SUP] 4 5 [/SUP], Pier P Sainaghi[SUP] 4 6 5 [/SUP]
Affiliations
- PMID: 32549532
- DOI: 10.23736/S0031-0808.20.04000-8
Abstract
Background: The coronavirus disease (COVID-19) outbreak is putting the European National Health Systems under pressure. Interestingly, Emergency Department (ED) referrals for reasons other than Covid-19 seem to have declined steeply. In the present paper, we aimed to verify how the Covid-19 outbreak changed ED referral pattern.
Methods: We retrospectively reviewed the clinical records of patients referred to the ED of a University Hospital in Northern Italy from 1st March to 13th April 2020. We compared the following data with those belonging to the same period in 2019: number of EDs accesses, rate of hospital admission, frequencies of the most common causes of ED referral, priority codes of access.
Results: The number of ED referrals during the Covid-19 outbreak was markedly reduced when compared to the same period in 2019 (3059 vs. 5691;-46.3%). Conversely, the rate of hospital admission raised from 16.9% to 35.4% (p<0.0001), with a shift toward higher priority codes of ED admission. In 2020, we observed both a reduction of the number of patients referred for both traumatic (513, 16.8% vs. 1544, 27.1%; χ2=118.7, p<0.0001) and non-traumatic (4147 vs. 2546) conditions. Among the latter, suspected Covid-19 accounted for 1101 (43.2%) accesses.
Conclusions: The Covid-19 pandemic completely changed the pattern of ED referral in Italy, with a marked reduction of the accesses to the hospitals. This could be related to a limited exposure to traumas and to a common fear of being infected during EDs in-stay. This may limit the misuse of EDs for non- urgent conditions, but may also delay proper referrals for urgent conditions.