Emergency department and hospital admissions and deaths from traffic injuries in Barcelona, Spain. A one-year population-based study

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.

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MALIGNANT MELANOMA. EPIDEMIOLOGY, ANALYTICAL INDICATORS OF THE EFFECTIVENESS OF ONCOLOGICAL SERVICES (POPULATION-BASED STUDY)

Problems in oncology ◽

10.37469/0507-3758-2017-63-2-221-233 ◽

2017 ◽

Vol 63 (2) ◽

pp. 221-233

Author(s):

Vakhtang Merabishvili

Keyword(s):

Malignant Melanoma ◽

Malignant Tumors ◽

The Elderly ◽

Population Based ◽

Special Treatment ◽

Detailed Structure ◽

Population Based Study ◽

Early Stages ◽

One Year ◽

Melanoma Epidemiology

Malignant melanoma of the skin (MMS) is less than 2% (1.74%) among all malignant tumors in Russia but this is more than 10,000 (10236-2015) of new cases. It is important to monitor the trend in dynamics of morbidity and mortality from this cause. From 1995 to 2015 a number of MMS primary cases was more than doubled in absolute numbers and “crude” rates. A slightly smaller increase is indicated by standardized indicators - 62.5% for men and 70.2% for women. Annually in Russia 3670 people die from MMS (2015), which is 1.2% of all cancer deaths. In recent years the previously revealed regularities have been largely preserved: lower rates of specific gravity detected in the early stages among people in the elderly and senile and in a smaller proportion in this group who received special treatment. At the same time a change in the detailed structure of the incidence of women has been revealed where currently the leading localization of MMS was not the lower extremities but the back. The index accuracy improved however the official statistics of the distribution of patients by stages of a disease was significantly distorted (weight of the early stages was increased from the real values). The index of one-year lethality and survival was significantly improved.

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Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Epilepsia ◽

10.1111/epi.16642 ◽

2020 ◽

Vol 61 (9) ◽

pp. 1969-1978

Author(s):

Churl‐Su Kwon ◽

Bonnie Wong ◽

Parul Agarwal ◽

Jung‐Yi Lin ◽

Madhu Mazumdar ◽

...

Keyword(s):

Health Services ◽

Hospital Admissions ◽

Health Services Utilization ◽

Population Based ◽

Population Based Study ◽

Services Utilization ◽

Discharge Disposition

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Functional Decline in Emergency Department Patients with Dyspnea; a Register-Based Cohort

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzab047 ◽

2021 ◽

Author(s):

Karoline Stentoft Rybjerg Larsen ◽

Marianne Lisby ◽

Hans Kirkegaard ◽

Annemette Krintel Petersen

Keyword(s):

Emergency Department ◽

Electronic Patient Record ◽

Hospital Admissions ◽

Functional Decline ◽

Patient Characteristics ◽

Risk Of Death ◽

Record Data ◽

Emergency Department Patients ◽

One Year ◽

Historic Cohort

Abstract Background Functional decline is associated with frequent hospital admissions and elevated risk of death. Presumably patients acutely admitted to hospital with dyspnea have a high risk of functional decline. The aim of this study was to describe patient characteristics, hospital trajectory, and use of physiotherapy services of dyspneic patients in an emergency department. Furthermore, to compare readmission and death among patients with and without a functional decline, and to identify predictors of functional decline. Methods Historic cohort study of patients admitted to a Danish Emergency Department using prospectively collected electronic patient record data from a Business Intelligence Registry of the Central Denmark Region. The study included adult patients that due to dyspnea in 2015 were treated at the emergency department (ED). The main outcome measures were readmission, death, and functional decline. Results In total 2,048 dyspneic emergency treatments were registered. Within 30 days after discharge 20% was readmitted and 3.9% had died. Patients with functional decline had a higher rate of 30-day readmission (31.2% vs. 19.1%, p<0.001) and mortality (9.3% vs. 3.6%, p=0.009) as well as mortality within one year (36.1% vs. 13.4%, p<0.001). Predictors of functional decline were age ≥60 years and hospital stay ≥6 days. Conclusion Patients suffering from acute dyspnea are seen at the ED at all hours. In total one in five patients were readmitted and 3.9% died within 30 days. Patients with a functional decline at discharge seems to be particularly vulnerable.

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Determinants of asthma-related emergency department return visits in adults: A population-based study

Canadian Journal of Respiratory Critical Care and Sleep Medicine ◽

10.1080/24745332.2021.1895006 ◽

2021 ◽

pp. 1-18

Author(s):

Chanel Kwok ◽

Yvonne DeWit ◽

Jennifer Olajos-Clow ◽

Carole Madeley ◽

Mona Jabbour ◽

...

Keyword(s):

Emergency Department ◽

Population Based ◽

Population Based Study ◽

Return Visits

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Incidence and mortality of ischemic stroke subtypes in Joinville, Brazil: a population-based study

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20150081 ◽

2015 ◽

Vol 73 (8) ◽

pp. 648-654 ◽

Cited By ~ 8

Author(s):

Marcos C. Lange ◽

Norberto L. Cabral ◽

Carla H. C. Moro ◽

Alexandre L. Longo ◽

Anderson R. Gonçalves ◽

...

Keyword(s):

Ischemic Stroke ◽

Population Based ◽

Large Artery ◽

Vessel Occlusion ◽

Population Based Study ◽

Incidence And Mortality ◽

One Year ◽

Undetermined Etiology ◽

And Control ◽

Adjusted Incidence

Aims To measure the incidence and mortality rates of ischemic stroke (IS) subtypes in Joinville, Brazil. Methods All first-ever IS patients that occurred in Joinville from January 2005 to December 2006 were identified. The IS subtypes were classified by the TOAST criteria, and the patients were followed-up for one year after IS onset. Results The age-adjusted incidence per 100,000 inhabitants was 26 (17-39) for large-artery atherosclerosis (LAA), 17 (11-27) for cardioembolic (CE), 29 (20-41) for small vessel occlusion (SVO), 2 (0.6-7) for stroke of other determined etiology (OTH) and 30 (20-43) for stroke of undetermined etiology (UND). The 1-year mortality rate per 100,000 inhabitants was 5 (2-11) for LAA, 6 (3-13) for CE, 1 (0.1-6) for SVO, 0.2 (0-0.9) for OTH and 9 (4-17) for UND. Conclusion In the population of Joinville, the incidences of IS subtypes were similar to those found in other populations. These findings highlight the importance of better detection and control of atherosclerotic risk factors.

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