Author:
Schranz Madlen,Boender T. Sonia,Greiner Timo,Kocher Theresa,Wagner Birte,Greiner Felix,Bienzeisler Jonas,Diercke Michaela,Grabenhenrich Linus,Brokmann Jörg,Mach Carsten,Wehler Markus,Blaschke Sabine,Esslinger Katrin,Schunk Domagoj,Wolfrum Sebastian,Hofmann Tobias,Lucas Benjamin,Klein Matthias,Peschel Thomas,Grupp Caroline,Wenderoth Hardy,Horn Oliver,Wrede Christian,Hoeger-Schmidt Heike,Dormann Harald,Ullrich Greta,Habbinga Kirsten,Henke Thomas,Schilling Tobias,Erdmann Bernadett,Wetzel Eckart,Baacke Markus,Grashey Rupert,Röhrig Rainer,Majeed Raphael,Kombeiz Alexander,Triefenbach Lucas,Walcher Felix,Schirrmeister Wiebke,Otto Ronny,Drynda Susanne,Aigner Annette,Ullrich Alexander,
Abstract
Abstract
Background
During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation behaviour of the population. To better understand those dynamics, we analysed routine data from emergency departments to quantify changes in consultation numbers, age distribution, disease acuity and day and hour of the day during different phases of the COVID-19 pandemic.
Methods
We used interrupted time series analyses to estimate relative changes for consultation numbers of 20 emergency departments spread throughout Germany. For the pandemic period (16-03-2020 – 13-06-2021) four different phases of the COVID-19 pandemic were defined as interruption points, the pre-pandemic period (06-03-2017 – 09-03-2020) was used as the reference.
Results
The most pronounced decreases were visible in the first and second wave of the pandemic, with changes of − 30.0% (95%CI: − 32.2%; − 27.7%) and − 25.7% (95%CI: − 27.4%; − 23.9%) for overall consultations, respectively. The decrease was even stronger for the age group of 0–19 years, with − 39.4% in the first and − 35.0% in the second wave. Regarding acuity levels, consultations assessed as urgent, standard, and non-urgent showed the largest decrease, while the most severe cases showed the smallest decrease.
Conclusions
The number of emergency department consultations decreased rapidly during the COVID-19 pandemic, without extensive variation in the distribution of patient characteristics. Smallest changes were observed for the most severe consultations and older age groups, which is especially reassuring regarding concerns of possible long-term complications due to patients avoiding urgent emergency care during the pandemic.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference34 articles.
1. Slagman A, Behringer W, Greiner F, Klein M, Weismann D, Erdmann B, et al. German forum of university emergency departments in the Society of University Clinics of Germany EV: medical emergencies during the COVID-19 pandemic. Dtsch Arztebl Int. 2020;117(33–34):545–52.
2. Boender TS, Greiner F, Kocher T, Schirrmeister W, Majeed RW, Bienzeisler J, et al. Inanspruchnahme deutscher Notaufnahmen während der COVID-19-Pandemie – der Notaufnahme-Situationsreport (SitRep). Epidemiologisches Bull. 2020;27:3–5.
3. Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11(3):e045343.
4. Hughes HE, Hughes TC, Morbey R, Challen K, Oliver I, Smith GE, et al. Emergency department use during COVID-19 as described by syndromic surveillance. Emerg Med J. 2020;37(10):600–4.
5. Wyatt S, Mohammed MA, Fisher E, McConkey R, Spilsbury P. Impact of the SARS-CoV-2 pandemic and associated lockdown measures on attendances at emergency departments in English hospitals: a retrospective database study. Lancet Regional Health Europe. 2021;100034:1–10.