The Demand for Hospital Emergency Services: Trends during the First Month of COVID-19 Response
The Demand for Hospital Emergency Services: Trends during the First Month of COVID-19 Response
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DOI：
10.1159/000507764
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发表时间：
2020-04-17
影响因子：
--
通讯作者：
Rocha JV
中科院分区：
文献类型：
--
作者：
Santana R;Sousa JS;Soares P;Lopes S;Boto P;Rocha JV
自2019年12月以来，全球已报告超过925，000例COVID-19病例，截至3月底，葡萄牙有8，251例。先前与SARS大流行相关的研究显示，急诊次数减少了80%。因此，本研究的目的是分析与历史记录相比，在第一个大流行月期间使用紧急服务的情况。从2014年1月至2020年3月，葡萄牙大陆紧急事件的数据从国家卫生服务（NHS）透明度门户网站和NHS监测网站下载。2020年3月至9月的紧急服务演变是根据2014年1月至2020年2月的历史数据预测的。2020年3月的信息由地区卫生管理局（RHA）和曼彻斯特分诊系统（MTS）在全球范围内预测。与预测值相比，2020年3月的紧急事件数量减少了48%。在RHA的分析中，阿连特茹的发病数量下降最小;有趣的是，阿连特茹也是葡萄牙大陆COVID-19病例较少的地区。在MTS的分析中，归类为黄色的发作显示出最高的减少（50%）。对于归类为紧急的事件，2020年3月期间的差异约为144，000次。这项初步研究的结果与以往大流行的证据一致。有关使用紧急服务，人口统计学和临床特征的事件的数据将是相关的，以分析这种减少。2020年3月，紧急服务的使用次数显著下降，尽管尚未确定减少的原因，但疫情开始与需求减少之间的关联是显而易见的。了解这一现象对于计划干预措施以避免因延迟急诊而导致的不必要的发病或死亡至关重要。
Since December 2019, more than 925,000 cases of COVID-19 have been reported worldwide, 8,251 cases in Portugal by the end of March. Previous studies related to the SARS pandemic showed a decrease up to 80% in the emergency care episodes. Hence, the objective of this study is to analyze the use of emergency services during the first pandemic month, compared to historical records. Data from emergency episodes in mainland Portugal, from January 2014 to March 2020, were downloaded from the National Health Service (NHS) Transparency Portal and the NHS monitoring website. The evolution of emergency services from March to September 2020 was forecasted based on historical data from January 2014 to February 2020. Information for March 2020 was forecasted globally, by the Regional Health Administration (RHA) and Manchester Triage System (MTS). Compared with forecasted values, there was a 48% reduction in the number of emergency episodes in March 2020. In the analysis by the RHA, Alentejo had the smallest decrease in the number of episodes; interestingly, Alentejo is also the area with fewer COVID-19 cases in mainland Portugal. In the analysis by the MTS, the episodes classified as yellow showed the highest reduction (50%). For episodes classified as urgent, there is a difference of about 144,000 episodes during March 2020. The results of this preliminary study are aligned with the evidence produced for previous pandemics. Data about the use of emergency services, demographic and clinical characteristics of the episodes would be relevant to analyze this reduction. There was a significant drop in the number of emergency service use in March 2020, and although the causes of this reduction are not determined, the association between the beginning of the pandemic and the reduction of demand is evident. Understanding this phenomenon is crucial to plan interventions to avoid unnecessary morbidities or deaths, caused by a delayed visit to the emergency department.
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