Davide Golinelli1, Francesca Campinoti2, Francesco Sanmarchi3, Simona Rosa4, Michelle Beleffi5, Gabriele Farina6, Andrea Tampieri7, Maria Pia Fantini8, Fabrizio Giostra9, Luca Santi10. 1. Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy. Electronic address: davide.golinelli@unibo.it. 2. Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy. Electronic address: campinotifrancesca@gmail.com. 3. Ospedale S. Maria della Scaletta, Dipartimento di Emergenza-urgenza e Accettazione, Unità Operativa di Pronto Soccorso e Medicina d'Urgenza, Viale Amendola, 2, 40026 Imola, Italy. Electronic address: francesco.sanmarchi@gmail.com. 4. Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy. Electronic address: simona.rosa@unibo.it. 5. Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy. 6. Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy. Electronic address: gabriele.farina@aosp.bo.it. 7. Ospedale S. Maria della Scaletta, Dipartimento di Emergenza-urgenza e Accettazione, Unità Operativa di Pronto Soccorso e Medicina d'Urgenza, Viale Amendola, 2, 40026 Imola, Italy. Electronic address: a.tampieri@ausl.imola.bo.it. 8. Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy. Electronic address: mariapia.fantini@unibo.it. 9. Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy. Electronic address: fabrizio.giostra@aosp.bo.it. 10. Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy. Electronic address: luca.santi@aosp.bo.it.
Abstract
BACKGROUND: Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases. METHODS: We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models. MAIN FINDINGS: We found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure. CONCLUSIONS: The two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.
BACKGROUND: Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases. METHODS: We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models. MAIN FINDINGS: We found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure. CONCLUSIONS: The two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.
Authors: Inese Gobiņa; Andris Avotiņš; Una Kojalo; Ieva Strēle; Santa Pildava; Anita Villeruša; Ģirts Briģis Journal: BMC Public Health Date: 2022-06-03 Impact factor: 4.135
Authors: Anna Slagman; Mareen Pigorsch; Felix Greiner; Wilhelm Behringer; Michael Bernhard; Jonas Bienzeisler; Sabine Blaschke; Volker Burst; Katharina Dechant; Michael Dommasch; Sebastian Ewen; André Gries; Felix Patricius Hans; Karl-Georg Kanz; Matthias Klein; Philipp Kümpers; Matthias Napp; Christopher Plata; Alexandra Ramshorn-Zimmer; Joachim Risse; Rainer Röhrig; Rajan Somasundaram; Domagoj Schunk; Felix Walcher; Thomas Walter; Dirk Weismann; Sebastian Wolfrum; Markus Wörnle; Yves Noel Wu; Martin Möckel Journal: Clin Res Cardiol Date: 2022-08-05 Impact factor: 6.138
Authors: Francesco Sanmarchi; Francesco Esposito; Emanuele Adorno; Francesco De Dominicis; Maria Pia Fantini; Davide Golinelli Journal: Z Gesundh Wiss Date: 2022-09-26