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. 2023 Feb 16;18(2):e0279105.
doi: 10.1371/journal.pone.0279105. eCollection 2023.

First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands

Robi Dijk  1 , Patricia Plaum  2 , Stan Tummers  3 , Frits H M van Osch  4   5 , Dennis G Barten  1 , Gideon H P Latten  3
Affiliations

First and second wave dynamics of emergency department utilization during the COVID-19 pandemic: A retrospective study in 3 hospitals in The Netherlands

Robi Dijk et al. PLoS One. .

Abstract

Objective: During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW, compared to 2019 reference periods.

Study design and methods: We performed a retrospective analysis of ED utilization in 3 Dutch hospitals in 2020. The FW and SW (March-June and September-December, respectively) were compared to the reference periods in 2019. ED visits were labeled as (non-)COVID-suspected.

Results: During the FW and SW ED visits decreased by 20.3% and 15.3%, respectively, when compared to reference periods in 2019. During both waves high urgency visits significantly increased with 3.1% and 2.1%, and admission rates (ARs) increased with 5.0% and 10.4%. Trauma related visits decreased by 5.2% and 3.4%. During the SW we observed less COVID-related visits compared to the FW (4,407 vs 3,102 patients). COVID-related visits were significantly more often in higher need of urgent care and ARs were at least 24.0% higher compared to non-COVID visits.

Conclusion: During both COVID-19 waves, ED visits were significantly reduced. ED patients were more often triaged as high urgent, the ED length of stay was longer and ARs were increased compared to the reference period in 2019, reflecting a high burden on ED resources. During the FW, the reduction in ED visits was most pronounced. Here, ARs were also higher and patient were more often triaged as high urgency. These findings stress the need to gain better insight into the motives of patients to delay or avoid emergency care during pandemics, as well as to better prepare EDs for future outbreaks.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overview of patients visiting the ED over 2019 and 2020.
See this image and copyright information in PMC

References

    1. WHO Director-General’s opening remarks at the media briefing on COVID-19–11 March 2020 [Internet]. WHO. 2020 [cited 2021 Apr 13]. Available from: https://www.who.int/director-general/speeches/detail/who-director-genera...
    1. O’Connor RD, Barten DG, Latten GHP. Preparations of Dutch emergency departments for the COVID-19 pandemic: A questionnaire-based study. Chen RJ, editor. PLoS One [Internet]. 2021. Sep 10 [cited 2021 Sep 25];16(9):e0256982. Available from: doi: 10.1371/journal.pone.0256982 - DOI - PMC - PubMed
    1. COVID-19 infecties op de verpleegafdeling [Internet]. Stichting-nice. 2020 [cited 2021 Apr 13]. Available from: https://www.stichting-nice.nl/covid-19-op-de-zkh.jsp
    1. Covid-19 op de IC [Internet]. Stichting-nice. 2020 [cited 2021 Apr 13]. Available from: https://www.stichting-nice.nl/covid-19-op-de-ic.jsp
    1. De belangrijkste actuele Corona cijfers: data uit 8 bronnen in 1 overzicht. (dagelijkse update!) | AlleCijfers.nl [Internet]. 2021 [cited 2021 Oct 10]. Available from: https://allecijfers.nl/nieuws/corona-virus-covid19-overzicht-belangrijks...

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