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Observational Study
. 2022 Jul 27;22(1):137.
doi: 10.1186/s12873-022-00694-6.

Examining patient flow in a tertiary hospital's emergency department at a low coronavirus prevalence region

Wen-Min Tseng  1 , Po-Hsiang Lin  1 , Pin-Chieh Wu  2   3   4 , Chih-Hsiang Kao  5
Affiliations
Observational Study

Examining patient flow in a tertiary hospital's emergency department at a low coronavirus prevalence region

Wen-Min Tseng et al. BMC Emerg Med. .

Abstract

Background: Taiwan's successful containment of the COVID-19 outbreak prior to 2021 provided a unique environment for the surveillance of unnecessary emergency medical use. The aim of the study is to examine the impact of the coronavirus disease (COVID-19) pandemic on the patient flow in the emergency department (ED) of a tertiary hospital over 1 year in southern Taiwan, a region with low COVID-19 prevalence.

Methods: Cross-sectional observational study was conducted from January to December 2020. Essential parameters of patient flow in the ED between January and February 2020 and the subsequent 11-month period were compared to data from 2019. Data were analyzed with descriptive statistics, using an independent sample t-test or Mann-Whitney U test, as applicable.

Results: The ED census showed an acute decline (- 30.8%) from January to February 2020, reaching its nadir (- 40.5%) in April 2020. From February to December 2020, there was an average decrease of 20.3% in ED attendance (p < 0.001). The impact was most significant in ambulatory visits, lower-urgency acuity (level III) visits, and pediatric visits, without change in the acuity proportion. The length of stay shortened mainly in the adult division, which typically had an overcrowding problem (median, 5.7-4.4 hours in discharge; 24.8-16.9 hours in hospitalization; p < 0.001). The incidence of 72-hour unscheduled return visits was also reduced (4.1-3.5%, p = 0.002).

Conclusions: In contrast to devastated regions, the impact on the ED patient flow in regions having low COVID-19 prevalence highlights a remodeling process of emergency medical care that would improve overcrowding.

Keywords: COVID-19 pandemic; Emergency department; Low prevalence; Overcrowding; Patient flow.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Taiwan’s monthly numbers of COVID-19 cases and visits to the Kaohsiung Veterans General Hospital emergency department in 2020
Fig. 2
Fig. 2
Comparison of daily visits to the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020
Fig. 3
Fig. 3
Changes in the number and percentage of visits by age groups to the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020
Fig. 4
Fig. 4
a. Comparison of monthly visits to adult division of the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020. b. Comparison of monthly visits to trauma division of the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020. c. Comparison of monthly visits to pediatric division of the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020
Fig. 5
Fig. 5
Comparison of length of stay of patients discharged or hospitalized from the Kaohsiung Veterans General Hospital emergency department between 2019 and 2020
See this image and copyright information in PMC

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