Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 10;10(6):1150.
doi: 10.3390/jcm10061150.

Impact of the COVID-19 Pandemic on the Loading and Quality of an Emergency Department in Taiwan: Enlightenment from a Low-Risk Country in a Public Health Crisis

Jamie Yu-Hsuan Chen  1   2 , Feng-Yee Chang  3 , Chin-Sheng Lin  4 , Chih-Hung Wang  5   6 , Shih-Hung Tsai  7 , Chia-Cheng Lee  1   8 , Sy-Jou Chen  7   9
Affiliations

Impact of the COVID-19 Pandemic on the Loading and Quality of an Emergency Department in Taiwan: Enlightenment from a Low-Risk Country in a Public Health Crisis

Jamie Yu-Hsuan Chen et al. J Clin Med. .

Abstract

The impact of the coronavirus disease 2019 (COVID-19) pandemic on health-care quality in the emergency department (ED) in countries with a low risk is unclear. This study aimed to explore the effects of the COVID-19 pandemic on ED loading, quality of care, and patient prognosis. Data were retrospectively collected from 1 January 2018 to 30 September 2020 at the ED of Tri-service general hospital. Analyses included day-based ED loading, quality of care, and patient prognosis. Data on triage assessment, physiological states, disease history, and results of laboratory tests were collected and analyzed. The number of daily visits significantly decreased after the pandemic, leading to a reduction in the time to examination. Admitted patients benefitted from the pandemic with a reduction of 0.80 h in the length of stay in the ED, faster discharge without death, and reduced re-admission. However, non-admitted visits with chest pain increased the risk of mortality after the pandemic. In conclusion, the COVID-19 pandemic led to a significant reduction in low-acuity ED visits and improved prognoses for hospitalized patients. However, clinicians should be alert about patients with chest pain due to their increased risk of mortality in subsequent admission.

Keywords: COVID-19; chest pain; emergency departments; length of stay; prognosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Daily visits to the emergency department (ED) by acuity and disease characteristics. The solid lines are the means and the areas are the 95% conference intervals. The dotted line is the divide between before and after the start of the COVID-19 pandemic.
Figure 2
Figure 2
Comparisons of wait time before and after the start of the COVID-19 pandemic. The bar chart and error bar demonstrate the mean and corresponding 95% conference intervals, and the p-value is tested by Student’s t-test. The annotations below bars are the number of patients and mean ± SD (hours).
Figure 3
Figure 3
Important prognostic analysis of selected patient groups before and after the start of the COVID-19 pandemic. The Kaplan–Meier curve demonstrates the prognostic difference before (red) and after (blue) the start of the COVID-19 pandemic. Values in the legend are the hazard ratios and corresponding 95% conference intervals based on the Cox proportional hazard model.
See this image and copyright information in PMC

References

    1. Li Q., Guan X., Wu P., Qun L., Xuhua G., Peng W., Xiaoye W., Lei Z., Yeqing T., Ruiqi R., et al. Early transmission dynamics in Wuhan, China, of Novel Coronavirus—Infected pneumonia. N. Engl. J. Med. 2020;382:1199–1207. doi: 10.1056/NEJMoa2001316. - DOI - PMC - PubMed
    1. McManus N.M., Offman R., Oetman J.D. Emergency Department Management of COVID-19: An Evidence-Based Approach. West. J. Emerg. Med. 2020;21:32–44. doi: 10.5811/westjem.2020.8.48288. - DOI - PMC - PubMed
    1. Mantica G., Riccardi N., Terrone C., Gratarola A. Non-COVID-19 visits to emergency departments during the pandemic: The impact of fear. Pub. Health. 2020;183:40–41. doi: 10.1016/j.puhe.2020.04.046. - DOI - PMC - PubMed
    1. Teo K.-C., Leung W.C., Wong Y.-K., Liu R.K., Chan A.H., Choi O.M., Kwok W.-M., Leung K.-K., Tse M.-Y., Cheung R.T., et al. Delays in Stroke Onset to Hospital Arrival Time During COVID-19. Stroke. 2020;51:2228–2231. doi: 10.1161/STROKEAHA.120.030105. - DOI - PMC - PubMed
    1. Lim Z.J., Reddy M.P., Afroz A., Billah B., Shekar K., Subramaniam A. Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis. Resuscitation. 2020;157:248–258. doi: 10.1016/j.resuscitation.2020.10.025. - DOI - PMC - PubMed

LinkOut - more resources