Wachira Wongtanasarasin1, Thanchanok Srisawang1, Wanwisa Yothiya2, Phichayut Phinyo3,4. 1. Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2. Nursing Service Division, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. 3. Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 4. Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Abstract
OBJECTIVE: To evaluate the impact of the national lockdown because of the 2019 coronavirus (COVID-19) pandemic towards the ED visits and admission rates in Thailand. METHODS: We retrospectively reviewed the electronic medical database of patients presenting to the ED during the national lockdown period (from 26 March to 30 June 2020). We used the same time interval in the year 2019 as the control period in our analysis. We collected baseline characteristics and outcomes of each patient in the ED. The primary outcome was the incidence rate ratio (IRR) with a 95% confidence interval (CI) of the average daily ED visits. Secondary outcomes included the IRR with 95% CI of total admissions and intensive care unit (ICU) admissions. RESULTS: The average number of daily ED visits decreased significantly from 89.1 to 57.0 (-36.0%, IRR 0.69, 95% CI 0.67-0.70). However, the proportions of 'Resuscitation' and 'Emergency' triage level were increased (29.1% vs 19.2%, P < 0.001). Total ED admission rate and ICU admission rate were also increased (33.5% vs 28.3%, P < 0.001 and 10.2% vs 7.5%, P < 0.001, respectively). The IRR for the admission rate was 1.18 (95% CI 1.11-1.26), and the IRR for the ICU admission rate was 1.35 (95% CI 1.21-1.52). CONCLUSION: The national lockdown in Thailand was associated with a significant reduction in average daily ED visits across traumatic and non-traumatic patients. Communication from healthcare professionals and public health officers is necessary to reinforce the importance of timely ED visits for acute health conditions.
OBJECTIVE: To evaluate the impact of the national lockdown because of the 2019 coronavirus (COVID-19) pandemic towards the ED visits and admission rates in Thailand. METHODS: We retrospectively reviewed the electronic medical database of patients presenting to the ED during the national lockdown period (from 26 March to 30 June 2020). We used the same time interval in the year 2019 as the control period in our analysis. We collected baseline characteristics and outcomes of each patient in the ED. The primary outcome was the incidence rate ratio (IRR) with a 95% confidence interval (CI) of the average daily ED visits. Secondary outcomes included the IRR with 95% CI of total admissions and intensive care unit (ICU) admissions. RESULTS: The average number of daily ED visits decreased significantly from 89.1 to 57.0 (-36.0%, IRR 0.69, 95% CI 0.67-0.70). However, the proportions of 'Resuscitation' and 'Emergency' triage level were increased (29.1% vs 19.2%, P < 0.001). Total ED admission rate and ICU admission rate were also increased (33.5% vs 28.3%, P < 0.001 and 10.2% vs 7.5%, P < 0.001, respectively). The IRR for the admission rate was 1.18 (95% CI 1.11-1.26), and the IRR for the ICU admission rate was 1.35 (95% CI 1.21-1.52). CONCLUSION: The national lockdown in Thailand was associated with a significant reduction in average daily ED visits across traumatic and non-traumatic patients. Communication from healthcare professionals and public health officers is necessary to reinforce the importance of timely ED visits for acute health conditions.
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