Elissa Rennert-May1,2,3,4,5, Jenine Leal1,2,4,6, Nguyen Xuan Thanh7, Eddy Lang8, Shawn Dowling8, Braden Manns1,3,4,9, Tracy Wasylak7, Paul E Ronksley1,4. 1. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 2. Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada. 3. Department of Medicine, University of Calgary, Calgary, Alberta, Canada. 4. O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada. 5. Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada. 6. Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada. 7. Strategic Clinical Networks, Alberta Health Services, Calgary, Alberta, Canada. 8. Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada. 9. Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Abstract
BACKGROUND: As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. METHODS: We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). FINDINGS: There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. CONCLUSIONS: Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.
BACKGROUND: As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. METHODS: We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). FINDINGS: There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. CONCLUSIONS: Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.
Authors: Leslie Rae Ferat; Ryan Forrest; Kawaldip Sehmi; Raul D Santos; David Stewart; Andrew J M Boulton; Beatriz Yáñez Jiménez; Phil Riley; Dylan Burger; Erika S W Jones; Maciej Tomaszewski; Maria Rita Milanese; Paul Laffin; Vivekanand Jha; Bettina Borisch; Michael Moore; Fausto J Pinto; Daniel Piñeiro; Jean-Luc Eiselé; Daniel T Lackland; Paul K Whelton; Xin-Hua Zhang; Anna Stavdal; Donald Li; Richard Hobbs; Jeyaraj Durai Pandian; Michael Brainin; Valery Feigin Journal: Glob Heart Date: 2021-10-12
Authors: Piotr Konrad Leszczyński; Paulina Sobolewska; Bożena Muraczyńska; Paulina Gryz; Adam Kwapisz Journal: Int J Environ Res Public Health Date: 2022-01-22 Impact factor: 3.390