Reduced rate of postpartum readmissions among homeless compared with non-homeless women in New York: a population-based study using serial, cross-sectional data

ObjectiveTo assess differences in rates of postpartum hospitalisations among homeless women compared with non-homeless women.DesignCross-sectional secondary analysis of readmissions and emergency department (ED) utilisation among postpartum women using hierarchical regression models adjusted for age, race/ethnicity, insurance type during delivery, delivery length of stay, maternal comorbidity index score, other pregnancy complications, neonatal complications, caesarean delivery, year fixed effect and a birth hospital random effect.SettingNew York statewide inpatient and emergency department databases (2009–2014).Participants82 820 and 1 026 965 postpartum homeless and non-homeless women, respectively.Main outcome measuresPostpartum readmissions (primary outcome) and postpartum ED visits (secondary outcome) within 6 weeks after discharge date from delivery hospitalisation.ResultsHomeless women had lower rates of both postpartum readmissions (risk-adjusted rates: 1.4% vs 1.6%; adjusted OR (aOR) 0.87, 95% CI 0.75 to 1.00, p=0.048) and ED visits than non-homeless women (risk-adjusted rates: 8.1% vs 9.5%; aOR 0.83, 95% CI 0.77 to 0.90, p<0.001). A sensitivity analysis stratifying the non-homeless population by income quartile revealed significantly lower hospitalisation rates of homeless women compared with housed women in the lowest income quartile. These results were surprising due to the trend of postpartum hospitalisation rates increasing as income levels decreased.ConclusionsTwo factors likely led to lower rates of hospital readmissions among homeless women. First, barriers including lack of transportation, payment or childcare could have impeded access to postpartum inpatient and emergency care. Second, given New York State’s extensive safety net, discharge planning such as respite and sober living housing may have provided access to outpatient care and quality of life, preventing adverse health events. Additional research using outpatient data and patient perspectives is needed to recognise how the factors affect postpartum health among homeless women. These findings could aid in lowering readmissions of the housed postpartum population.

Download Full-text

Abstract P220: Disparity In Hospital Admissions And Length Of Stay Based On Income Status For Emergency Department Hypertensive Crisis Visits: A Cross-sectional Study Using The Nationwide Emergency Department Sample

Hypertension ◽

10.1161/hyp.78.suppl_1.p220 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Shreya Srivastava ◽

Bhargav Vemulapalli ◽

Alexis K Okoh ◽

John Kassotis

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Regression Model ◽

Household Income ◽

Hypertensive Crisis ◽

Cross Sectional ◽

Delivery Of Care ◽

Income Status ◽

Ed Visits ◽

Income Quartile

Introduction: Racial, gender and lower socioeconomic status have been shown to negatively impact the delivery of care. How this impacts the management of hypertensive crisis (HC) remains unclear. Objective: Identify disparities on admission frequency and length of stay (LOS) among those presenting with HC, as a function of household income. Methods: This is a cross-sectional analysis of 2016 ED visits and supplemental Inpatient data from the Nationwide Emergency Department Sample. Median household income quartiles were established. A multivariable logistic regression model was used to estimate odds of admission in each income quartile. A multivariable linear regression model was used to predict LOS. Results: After applying sample weighting, the total number of ED visits was 33,728 with 25442, 6906, and 1380 visits for hypertensive urgency (HU), emergency (HE) and unspecified crisis, respectively. There were 13191, 8889, 6401, 5247 visits in the (1 st ) lowest, 2 nd , 3 rd and 4 th (highest) income quartiles, respectively. The median age was 61 and 58 years for HU and HE, respectively. The most common comorbidity was chronic kidney disease. Individuals with the highest income, had a lower odds of admission compared to the lowest quartile [Adjusted Odds Ratio: 0.41, 95% CI: 0.22,0.74] ( Figure 1a ). There was a significant linear association between income quartile and LOS across all HC and HE [beta coefficient: 0.411, 0.407 p value = 0.015, 0.019] ( Figure 1b ). Conclusions: In this study, patients with lower income were more likely to be admitted, while those with higher income exhibited a longer LOS. Clinicians must be made aware these disparities to ensure the equitable delivery of care.

Download Full-text

Emergency department revisits and rehospitalizations among infants and toddlers for acute allergic reactions

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210031 ◽

2021 ◽

Vol 42 (3) ◽

pp. 247-256

Author(s):

Lacey B. Robinson ◽

Anna Chen Arroyo ◽

Rebecca E. Cash ◽

Susan A. Rudders ◽

Carlos A. Camargo

Keyword(s):

Health Care ◽

Emergency Department ◽

New York ◽

Health Care Utilization ◽

Population Based ◽

Care Utilization ◽

Allergic Reactions ◽

Infants And Toddlers ◽

Ed Visits ◽

Total Charges

Background and Objective: Allergic reactions, including anaphylaxis, are rising among children. Little is known about health care utilization among infants and toddlers. Our objective was to characterize health care utilization and charges for acute allergic reactions (AAR). Methods: We conducted a retrospective cohort study of trends in emergency department (ED) visits and revisits, hospitalizations and rehospitalizations, and charges among infants and toddlers (ages < 3 years), with an index ED visit or hospitalization for AAR (including anaphylaxis). We used data from population-based multipayer data: State Emergency Department Databases and State Inpatient Databases from New York and Nebraska. Multivariable logistic regression was used to identify factors associated with ED revisits and rehospitalizations. Results: Between 2006 and 2015, infant and toddler ED visits for AAR increased from 27.8 per 10,000 population to 35.2 (Ptrend < 0.001), whereas hospitalizations for AAR remained stable (Ptrend = 0.11). In the one year after an index AAR visit, 5.1% of these patients had at least one AAR ED revisit and 5.9% had at least one AAR rehospitalization. Factors most strongly associated with AAR ED revisits included an index visit hospitalization and receipt of epinephrine. Total charges for AAR ED visits (2009‐2015) and hospitalizations (2011‐2015) were more than $29 million and $11 million, respectively. Total charges increased more than fourfold for both AAR ED revisits for AAR rehospitalizations during the study period. Conclusion: Infants and toddlers who presented with an AAR were at risk for ED revisits and rehospitalizations for AAR within the following year. The charges associated with these revisits were substantial and seemed to be increasing.

Download Full-text

Prior Frequent Emergency Department Use as a Predictor of Emergency Department Visits After a New Cancer Diagnosis

JCO Oncology Practice ◽

10.1200/op.20.00889 ◽

2021 ◽

pp. OP.20.00889

Author(s):

Arthur S. Hong ◽

Danh Q. Nguyen ◽

Simon Craddock Lee ◽

D. Mark Courtney ◽

John W. Sweetenham ◽

...

Keyword(s):

Emergency Department ◽

Cancer Diagnosis ◽

Negative Binomial ◽

Academic Medical Center ◽

Safety Net ◽

Emergency Department Visits ◽

Patients With Cancer ◽

Safety Net Hospital ◽

Ed Visits ◽

After Cancer

PURPOSE: To determine whether emergency department (ED) visit history prior to cancer diagnosis is associated with ED visit volume after cancer diagnosis. METHODS: This was a retrospective cohort study of adults (≥ 18 years) with an incident cancer diagnosis (excluding nonmelanoma skin cancers or leukemia) at an academic medical center between 2008 and 2018 and a safety-net hospital between 2012 and 2016. Our primary outcome was the number of ED visits in the first 6 months after cancer diagnosis, modeled using a multivariable negative binomial regression accounting for ED visit history in the 6-12 months preceding cancer diagnosis, electronic health record proxy social determinants of health, and clinical cancer-related characteristics. RESULTS: Among 35,090 patients with cancer (49% female and 50% non-White), 57% had ≥ 1 ED visit in the 6 months immediately following cancer diagnosis and 20% had ≥ 1 ED visit in the 6-12 months prior to cancer diagnosis. The strongest predictor of postdiagnosis ED visits was frequent (≥ 4) prediagnosis ED visits (adjusted incidence rate ratio [aIRR]: 3.68; 95% CI, 3.36 to 4.02). Other covariates associated with greater postdiagnosis ED use included having 1-3 prediagnosis ED visits (aIRR: 1.32; 95% CI, 1.28 to 1.36), Hispanic (aIRR: 1.12; 95% CI, 1.07 to 1.17) and Black (aIRR: 1.21; 95% CI, 1.17 to 1.25) race, homelessness (aIRR: 1.95; 95% CI, 1.73 to 2.20), advanced-stage cancer (aIRR: 1.30; 95% CI, 1.26 to 1.35), and treatment regimens including chemotherapy (aIRR: 1.44; 95% CI, 1.40 to 1.48). CONCLUSION: The strongest independent predictor for ED use after a new cancer diagnosis was frequent ED visits before cancer diagnosis. Efforts to reduce potentially avoidable ED visits among patients with cancer should consider educational initiatives that target heavy prior ED users and offer them alternative ways to seek urgent medical care.

Download Full-text

101 National Trends in Emergency Department Ondansetron Use and Clinical Outcomes Among Children with Acute Gastroenteritis

Paediatrics & Child Health ◽

10.1093/pch/pxab061.082 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e72-e73

Author(s):

Sarah Rogers ◽

Stephen Freedman ◽

Terry Klassen ◽

Brett Burstein

Keyword(s):

Emergency Department ◽

Acute Gastroenteritis ◽

Multivariable Analysis ◽

Population Level ◽

Subject Area ◽

Fluid Administration ◽

Cross Sectional ◽

Ed Visits ◽

Nationally Representative ◽

Over Time

Abstract Primary Subject area Emergency Medicine - Paediatric Background Acute gastroenteritis (AGE) is among the most common illnesses for which children are evaluated in the Emergency Department (ED). Among children with AGE, ondansetron has been shown to reduce vomiting, intravenous (IV) fluid administration and hospitalizations when administered in the ED. Objectives To determine whether increasing ondansetron administration is associated with a concomitant decline in IV rehydration and hospitalization among children presenting with AGE in a broad, nationally representative ED sample. Design/Methods This was a cross-sectional analysis of the US Centers for Disease Control and Prevention (CDC) National Hospital Ambulatory Medical Care Survey (NHAMCS) database from 2006 to 2015. Children < 18 years old with a discharge diagnosis of AGE were included for analysis. Survey weighting procedures were applied to generate population-level estimates and to perform multivariable logistic regression to identify factors associated with ondansetron administration. Results There were an estimated 15.1 million (95% CI 13.5-16.7) visits for AGE during the 10-year study period. AGE visits increased as a proportion of all pediatric ED visits over time (4.6% in 2006, 5.7% in 2015; p-trend=0.013). The mean patient age was 4.7 (95% CI 4.5-5.0) years, and most visits were to non-teaching (86.6%, 95% CI 83.3-89.3%) and non-pediatric (83.4%, 95% CI 78.2-87.5%) hospitals. The proportion of patients receiving ondansetron increased over time (11.8% in 2006, 62.5% in 2015; p-trend < 0 .001), both in the ED (10.6% in 2006, 55.5% in 2015; p-trend < 0 .001) and as outpatient prescriptions (3.3% in 2006, 45.3% in 2015; p-trend < 0 .001). Over the same period, there was no change in hospitalizations (2.9% overall, 95% CI 2.2-3.7%; p-trend=0.144). IV hydration for AGE decreased (31.8% in 2006, 24.9% in 2015; p-trend < 0 .048), as did IV fluid administration across all other pediatric ED visits (10.3% in 2006, 7.8% in 2015; p-trend < 0 .023). After adjustment for patient- and hospital-level factors, the odds ratio for IV rehydration among children with AGE was 0.97 (95% CI 0.92-1.01). Multivariable analysis found younger age (aOR 0.94, 95% CI 1.04-1.09), Medicaid/Medicare insurance (aOR 0.74; 95% CI 0.57-0.97), and presentation to a teaching hospital (aOR 0.74; 95% CI 0.54-0.99) were inversely associated with ondansetron administration. Other antiemetics most commonly used were promethazine (7.4%, 95% CI 5.9-9.2%), metoclopramide (1.8%, 95% CI 1.3-2.5%) and trimethobenzamide (1.5%, 95% CI 1.1-2.1%). Antimotility agents, H2-receptor blockers, and probiotics were infrequently used. Conclusion Both ED and outpatient prescribing of ondansetron for children with AGE increased; however, no concomitant decline was observed in hospitalizations or IV rehydration. Guidelines and quality improvement efforts are needed to target ondansetron administration to children most likely to benefit to minimize adverse events and costs associated with overuse.

Download Full-text

Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

Journal of Primary Care & Community Health ◽

10.1177/2150132720926276 ◽

2020 ◽

Vol 11 ◽

pp. 215013272092627

Author(s):

Julia Ellbrant ◽

Jonas Åkeson ◽

Helena Sletten ◽

Jenny Eckner ◽

Pia Karlsland Åkeson

Keyword(s):

Primary Care ◽

Emergency Department ◽

Patient Characteristics ◽

Pediatric Emergency ◽

Emergency Department Visits ◽

University Hospital ◽

Pediatric Emergency Department ◽

Hospital Data ◽

Cross Sectional ◽

Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

Download Full-text

Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency

American Journal of Medical Quality ◽

10.1177/1062860619861947 ◽

2019 ◽

Vol 35 (3) ◽

pp. 252-257 ◽

Cited By ~ 1

Author(s):

Ryan F. Coughlin ◽

David Peaper ◽

Craig Rothenberg ◽

Marjorie Golden ◽

Marie-Louise Landry ◽

...

Keyword(s):

Emergency Department ◽

Decision Support ◽

Electronic Health Record ◽

Urine Culture ◽

Diagnostic Yield ◽

Secondary Outcome ◽

Health Record ◽

Diagnostic Efficiency ◽

Ed Visits ◽

Electronic Health

The authors evaluated the effectiveness of an electronic health record (EHR)-based reflex urine culture testing algorithm on urine test utilization and diagnostic yield in the emergency department (ED). The study implemented a reflex urine culture order with EHR decision support. The primary outcome was the number of urine culture orders per 100 ED visits. The secondary outcome was the diagnostic yield of urine cultures. After the intervention, the mean number of urine cultures ordered was 5.95 fewer per 100 ED visits (9.3 vs 15.2), and there was a decrease in normal, or negative, cultures by 2.42 per 100 ED visits. There also was a statistically significant decrease in urine culture utilization and an increase in the positive proportion of cultures. Simple EHR clinical decision-support tools along with reflex urine culture testing can significantly reduce the number of urine cultures performed while improving diagnostic yield in the ED.

Download Full-text

P118: Older adults in the emergency department: a retrospective cross-sectional study of the geriatric population in Edmonton emergency departments

CJEM ◽

10.1017/cem.2019.309 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S106-S107

Author(s):

K. Morch ◽

R. Schonnop ◽

A. Gauri ◽

D. Ha

Keyword(s):

Older Adults ◽

Emergency Department ◽

Geriatric Patient ◽

Geriatric Patients ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Health Region ◽

Area Of Interest ◽

Ed Visits

Introduction: The geriatric patient population accounts for an ever increasing proportion of emergency department (ED) visits. Geriatric centered EDs are an emerging area of interest and research. Though there have been past studies looking at older patient presentations at individual hospitals, there is limited data describing geriatric presentations within an entire Canadian geographic health region. This study characterizes the population of older adults utilizing the EDs in the Edmonton Zone, a health region that comprises a total of eleven tertiary (T), urban community (UC) and rural community (RC) hospitals. Methods: This retrospective cross-sectional study targeted all patients ≥65 years presenting to the Edmonton Zone EDs between April 1, 2017 to March 31, 2018. Data was extracted from the Emergency Department Information System (EDIS) database for ten EDs in the health region. Clinical and administrative data points were extracted and examined for each site. Results: We analyzed 100,813 ED geriatric patient visits during our study period, accounting for 18.7% of total ED visits to the Edmonton Zone. The five most common triage complaints at ED presentation were shortness of breath, abdominal pain, chest pain with cardiac features, general weakness, and back pain. CTAS scores 1-3 were assigned to 77.8% of geriatric presentations (T: 86.3%, UC: 77.4%, RC: 60.9%). 27.3% of geriatric patients had presented to an ED within the past 30 days (T: 30.0%, UC: 25.4%, RC: 27.7%). On average, 35.3% of older adult ED visits involved a consultation (T: 51.7%, UC 30.8%, RC 14.6%) and approximately 25% of geriatric patients were admitted to hospital during their ED visit (T: 42.8%, UC: 19.4%, RC: 7.1%). The average length of stay (LOS) in the ED (hh:mm) was 10:19 (T: 10:24, UC: 11:38, RC: 5:43). Overall, 2.4% of all geriatric patients left an ED without being seen after initial registration (T: 2.7%, UC: 2.2%, RC: 2.1%). Conclusion: Older adults represent a significant proportion of the ED visits in the Edmonton Zone. The triage acuity, LOS, re-presentation, consultation and admission rates varied based on the type of ED, which has implications for resource allocation within the health region. Our results can also direct future targeted initiatives and quality improvement projects to the various types of EDs in the Edmonton Zone, and facilitate planning of ED services for older adults in other health regions who have a similar geographic distribution of care sites.

Download Full-text

Relationship of emergency department use pre- and post-cancer diagnosis in safety-net adults.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.6626 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 6626-6626

Author(s):

Arthur Hong ◽

Navid Sadeghi ◽

John Vernon Cox ◽

Simon Craddock Lee ◽

Ethan Halm

Keyword(s):

Emergency Department ◽

Cancer Diagnosis ◽

Initial Treatment ◽

Safety Net ◽

Urgent Care ◽

Cancer Type ◽

Advanced Stage ◽

Seeking Behavior ◽

Ed Visits ◽

Advanced Stage Cancer

6626 Background: Safety-net adults generate a high rate of emergency department (ED) visits within the 180 days after a new cancer diagnosis, many of which could be alternatively triaged to an urgent care clinic. It is unclear how much of this ED use is attributable to the cancer and treatment vs. ED-seeking behavior. To identify patients at risk of frequent ED use, we explored whether a patient’s pre-cancer ED visit use predicted ED use after diagnosis. Methods: We identifiably linked adults from the tumor registry in the Dallas County safety-net health system to a regional hospital database with claims-like data for all patients from 98% of non-federal hospitals in North Texas. We applied a mixed-effects multivariate logit model, using frequent ED use (≥4 visits) in the 6-12 months or 12-18 months before diagnosis to predict frequent ED use after diagnosis, adjusting for demographics, comorbidities; cancer type, stage, initial treatment modalities; and grouping visits at the patient level. Results: Of 8,610 adults diagnosed from 2012-2016, 76.2% had Medicaid or were uninsured, 30.9% had lung, breast, or colorectal cancer, and 25.9% had advanced-stage cancer at diagnosis. In the 180 days after diagnosis, 42.5% of patients had zero ED visits, 45.7% had 1-3 visits, and 11.8% were frequent ED users (≥4). In multivariate analysis, patients with frequent ED use in the 6-12 months before a cancer diagnosis had 6.7 higher odds (95% CI: 4.8, 9.3) of having frequent ED use after diagnosis, compared to patients who had zero ED visits prior to diagnosis. This compared to 1.3 higher odds (95% CI: 1.1, 1.5) of frequent ED use if the patient had advanced-stage cancer, and 2.1 higher odds (95% CI: 1.8, 2.4) if chemotherapy was part of initial treatment. Although most post-diagnosis frequent ED users generated zero visits (62.2%) or 1-3 visits (30.7%) in the 6-12 months prior to diagnosis, 38% of patients with frequent ED use pre-diagnosis continued frequent ED visits after diagnosis. Results were similar for ED use 12-18 months prior to diagnosis. Conclusions: Among safety-net adults, prior ED-seeking behavior strongly predicted ED use after a new cancer diagnosis. This may represent a high-risk group that might benefit from care delivery innovation.

Download Full-text

P090: Comparing patients who leave the emergency department prematurely, before versus after medical evaluation: a NHAMCS analysis

CJEM ◽

10.1017/cem.2016.266 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S108-S108

Author(s):

J. Moe ◽

J.B. Belsky

Keyword(s):

Emergency Department ◽

Medical Care ◽

Private Insurance ◽

High Risk Patient ◽

Target Population ◽

Medical Professional ◽

Medical Provider ◽

Cross Sectional ◽

Medical Evaluation ◽

Ed Visits

Introduction: Many patients leave the Emergency Department (ED) before beginning or completing medical evaluation. Some of these patients may be at higher medical risk depending on their timing of leaving the ED. The objective of this study was to compare patient, hospital, and visit characteristics of patients leaving prior to completing medical care in the ED either before or after evaluation by a medical provider. Methods: This is a retrospective cross-sectional analysis of ED visits using the 2009-2011 National Hospital Ambulatory Medical Care Survey. The target population was identified by coded dispositions corresponding to leaving prior to completing medical care, and two groups were defined based on whether or not they had been evaluated by a medical professional. Data are reported as means (with standard errors) and proportions, and bivariate and multivariate logistic regressions were performed. All analysis was performed using SAS 9.4 and SUDAAN 11.0.1 to account for the complex sample design. Results: 100,962 ED visits were documented from 2009-2011, representing a weighted count of 402,211,907 total ED visits. 2,646 (3%) resulted in a disposition of left without completing medical care. Of these visits, 1,792 (68%) left prior to being seen by a medical provider versus 854 (32%) who left after medical provider evaluation. Patients who left after being assessed by a medical provider were older, had higher acuity visits, were more likely to have visited an ED without nursing triage, more likely to have arrived by ambulance, and more likely to have private insurance than other payment arrangements (e.g. worker’s compensation or charity). Conclusion: When comparing all patients who left the ED prior to completion of care, those who left after versus before medical provider evaluation differed in their patient, hospital, and visit characteristics and may represent a high risk patient group.

Download Full-text

COVID-19 Pandemic Impact on Emergency Department Visits and Quality of Service: A Comparative Cross-Sectional Study in a Tertiary Centre

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i58b34227 ◽

2021 ◽

pp. 471-483

Author(s):

Maram Mohammed Jaboua ◽

Warif Jameel Abdulhaq ◽

Nada Saeed Almuntashiri ◽

Sarah Saud Almohammdi ◽

Asayel Qeblan Aldajani ◽

...

Keyword(s):

Emergency Department ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Critical Conditions ◽

Sectional Study ◽

Cross Sectional ◽

Coronary Syndrome ◽

Number Of Patients ◽

Ed Visits

Background: The COVID-19 pandemic has contributed to a devastating impact on emergency departments worldwide, resulting in a global crisis with various health consequences. We aimed to evaluate this impact on an emergency department (ED) visit of critical conditions such as Acute Coronary Syndrome (ACS), Cerebrovascular accident (CVA), Sepsis and Febrile neutropenia (FN), and to assess the quality of the ED after new adaptive measures were applied. Methods: This is a comparative cross-sectional study to assess the number of patients who presented to the ED of King Abdullah Medical city with the specified diagnosis. We collected data via the E-medical records. We compared the data over three periods pre-lockdown, lockdown and post lockdown in years 2019-2021. For quality measurement, Adaa (Ministry of Health's program) was used to calculate the percentage of patients who stayed 4 hours or less in the ED. Results: The total number of ED visits in the specified periods of study was 8387. The total numbers of patients for 2019, 2020, and 2020 respectively were 2011 (, ACS 70.4%, CVA 16.3%, sepsis and FN 13.3%.), 2733 (ACS 73.1%, CVA 9.9%, sepsis and FN 17.0%), and 3643 (ACS 64.0%, CVA 19.4%, sepsis and FN 16.7). The average percentage of patients who stayed 4 hours or less in the ED was 60% and 57.5% for 2020 and 2021, respectively. Conclusion: Although we expected reductions in ED visits during COVID-19 periods, we found that visits were rising through the years 2019-2021.

Download Full-text