Yıl: 2021 Cilt: 59 Sayı: 2 Sayfa Aralığı: 96 - 102 Metin Dili: İngilizce DOI: 10.4274/haseki.galenos.2021.6601 İndeks Tarihi: 21-05-2021

How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study

Öz:
Aim: During the coronavirus disease-2019 (COVID-19) pandemic, the strict limitations imposed on access to many healthcare institutions may effect emergency department (ED) attendances with regards to appropriateness. Thus, this study aimed to investigate the urgency level of ED attendances and the frequency of inappropriate use (IU) during the COVID-19 pandemic.Methods: A prospective cross-sectional study was conducted in the university hospital ED during one week (May 11-17, 2020) of the post-peak period of the first wave of the COVID-19 pandemic. All adult (≥18 years) ED attendances were evaluated by emergency residents in terms of clinical and demographic characteristics and appropriateness. The data were recorded on data collection forms.Results: IU rate detected was 45.1%. In the study, 3.9% and 9.5% of attendances were in Emergency Severity Index categories 1 and 2, respectively. A significant negative correlation was found between age and IU (odds ratio=0.978; 95% confidence interval: 0.96-0.99). According to the binary logistic regression analysis, it is most likely that IUs are young people who are employed and have no chronic disease.Conclusion: This study showed that the frequency of IU decreased while the urgency level of the ED attendances increased in the post-peak period of the pandemic compared to a previous study conducted outside of the pandemic, in the same center. There was an inverse relationship between IU frequency and age. The results will help with planning ED services in future pandemic periods.
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  • 1. World Health Organization. Emergency WHO Director General’s opening remarks at the media briefing on COVID-19-11 March 2020. Available from: https://www.who. int/director-general/speeches/detail/who-director-general s-opening-remarks-at-the-media-briefing-on-covid-19---11- march-2020
  • 2. Perlini S, Canevari F, Cortesi S, et al. Emergency Department and Out-of-Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre. Intern Emerg Med 2020;15:825-33.
  • 3. Cao Y, Li Q, Chen J, et al. Hospital Emergency Management Plan During the COVID-19 Epidemic. Acad Emerg Med 2020;27:309-11.
  • 4. Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits-United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:699-704.
  • 5. Wong LE, Hawkins JE, Langness S, et al. Where are all the patients? Addressing COVID-19 fear to encourage sick patients to seek emergency care. NEJM Catalyst 2020.
  • 6. Brick A, Walsh B, Keegan C, Lyons S. COVID-19 and emergency department attendances in Irish public hospitals. ESRI Series QEC Special Article Dublin. Accessed 2020;1-18.
  • 7. Chen TA, Lai KH, Chang HT. Impact of a severe acute respiratory syndrome outbreak in the emergency department: an experience in Taiwan. Emerg Med J 2004;21:660-2.
  • 8. NHS Hull University Teaching Hospital. Help keep Hull’s A&E for medical emergencies during COVID-19. Available from: https://www.hey.nhs.uk/news/2020/05/05/help-keep-hulls ae-for-medical-emergencies-during-covid-19/. Accessed June 25, 2020.
  • 9. Carret ML, Fassa AC, Domingues MR. Inappropriate use of emergency services: a systematic review of prevalence and associated factors. Cad Saude Publica 2009;25:7-28.
  • 10. Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: systematic literature review. Am J Manag Care 2013;19:47- 59.
  • 11. Weinick RM, Burns RM, Mehrotra A. Many emergency department visits could be managed at urgent care centers and retail clinics. Health Aff (Millwood) 2010;29:1630-6.
  • 12. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One 2018;13:203316.
  • 13. Moskop JC. Nonurgent care in the emergency department bane or boon? Virtual Mentor 2010;12:476-82.
  • 14. Uppal A, Silvestri DM, Siegler M, et al. Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic. Health Aff (Millwood) 2020;39:1443-9.
  • 15. Gunduz A, Topbaş M, Gursoy A, et al. Evaluation of frequency, causes of inappropriate attendance to the emergency departments and relationship to overcrowding in Trabzon Province. TUBITAK 3001-Starting R&D Projects Support Program, No: 216S973;2018.
  • 16. Pala K. COVID-19 pandemic in Turkey. Turkish Physicians Association Sixth Month Evaluation Report for COVID-19 Pandemic. Available from: https://www.ttb.org.tr/ kutuphane/covid19-rapor_6/covid19-rapor_6_Part15.pdf. Accessed February 2, 2021.
  • 17. Keskinkilic B, Shaikh I, Tekin A, Ursu P, Mese EA. World Health Organization. Turkey’s response to COVID-19: first impressions 2020;1-23.
  • 18. T.C. Official newspaper. Communique on the Application Procedures and Principles of Emergency Services in Inpatient Health Institution. 16.10.2009. Sayı: 27378, Prime Ministry Printing House, Ankara.
  • 19. Fernandes CM, Tanabe P, Gilboy N, et al. Five-level triage: a report from the ACEP/ENA Five-level Triage Task Force. J Emerg Nurs 2005;31:39-50.
  • 20. Çınar O, Çevik E, Salman N, Cömert B. Emergency Severity Index triage system and implementation experience in a university hospital. Turk J Emerg Med 2010;10:126-31.
  • 21. Czeisler MÉ, Marynak K, Clarke KEN, et al. Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns - United States, June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1250-7.
  • 22. Tsai JC, Liang YW, Pearson WS. Utilization of emergency department in patients with non-urgent medical problems: patient preference and emergency department convenience. J Formos Med Assoc 2010;109:533-42.
  • 23. McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Med 2013;11:258.
  • 24. O’Keeffe C, Mason S, Jacques R, Nicholl J. Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data. PLoS One 2018;13:192855.
  • 25. Eroglu SE, Toprak SN, Urgan O, et al. Evaluation of non-urgent visits to a busy urban emergency department. Saudi Med J 2012;33:967-72.
  • 26. Hakkoymaz H, Okyay RA. How appropriate are the emergency department admissions? A study from a tertiary hospital emergency department. EJMI 2020;4:353-9.
  • 27. Miyazawa A, Maeno T, Shaku F, et al. Inappropriate use of the emergency department for nonurgent conditions: patient characteristics and associated factors at a Japanese hospital. J Gen Fam Med 2019;20:146-53.
  • 28. Jalili M, Shirani F, Hosseininejad M, Asl-e-Soleimani H. Emergency department nonurgent visits in Iran: prevalence and associated factors. Am J Manag Care 2013;19:1-8.
  • 29. Lennox A, Braaf S, Smit DV, Cameron P, Lowthian JA. Caring for older patients in the emergency department: Health professionals’ perspectives from Australia-The Safe Elderly Emergency Discharge project. Emergency Medicine Australasia 2019;31:83-9.
  • 30. Idil H, Kilic TY, Toker İ, Dura Turan K, Yesilaras M. Non-urgent adult patients in the emergency department: Causes and patient characteristics. Turk J Emerg Med.2018;18:71-4.
  • 31. Raven MC, Lowe RA, Maselli J, Hsia RY. Comparison of presenting complaint vs discharge diagnosis for identifying “nonemergency” emergency department visits. JAMA 2013;309:1145-53.
APA ŞİMŞEK P, İLHAN E, BÜLBÜL Ö, ÜÇÜNCÜ E, TOPBAS M, GÜNDÜZ A (2021). How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. , 96 - 102. 10.4274/haseki.galenos.2021.6601
Chicago ŞİMŞEK Perihan,İLHAN ENGİN,BÜLBÜL Özlem,ÜÇÜNCÜ Esra,TOPBAS MURAT,GÜNDÜZ ABDÜLKADIR How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. (2021): 96 - 102. 10.4274/haseki.galenos.2021.6601
MLA ŞİMŞEK Perihan,İLHAN ENGİN,BÜLBÜL Özlem,ÜÇÜNCÜ Esra,TOPBAS MURAT,GÜNDÜZ ABDÜLKADIR How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. , 2021, ss.96 - 102. 10.4274/haseki.galenos.2021.6601
AMA ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. . 2021; 96 - 102. 10.4274/haseki.galenos.2021.6601
Vancouver ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. . 2021; 96 - 102. 10.4274/haseki.galenos.2021.6601
IEEE ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A "How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study." , ss.96 - 102, 2021. 10.4274/haseki.galenos.2021.6601
ISNAD ŞİMŞEK, Perihan vd. "How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study". (2021), 96-102. https://doi.org/10.4274/haseki.galenos.2021.6601
APA ŞİMŞEK P, İLHAN E, BÜLBÜL Ö, ÜÇÜNCÜ E, TOPBAS M, GÜNDÜZ A (2021). How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. Haseki Tıp Bülteni, 59(2), 96 - 102. 10.4274/haseki.galenos.2021.6601
Chicago ŞİMŞEK Perihan,İLHAN ENGİN,BÜLBÜL Özlem,ÜÇÜNCÜ Esra,TOPBAS MURAT,GÜNDÜZ ABDÜLKADIR How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. Haseki Tıp Bülteni 59, no.2 (2021): 96 - 102. 10.4274/haseki.galenos.2021.6601
MLA ŞİMŞEK Perihan,İLHAN ENGİN,BÜLBÜL Özlem,ÜÇÜNCÜ Esra,TOPBAS MURAT,GÜNDÜZ ABDÜLKADIR How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. Haseki Tıp Bülteni, vol.59, no.2, 2021, ss.96 - 102. 10.4274/haseki.galenos.2021.6601
AMA ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. Haseki Tıp Bülteni. 2021; 59(2): 96 - 102. 10.4274/haseki.galenos.2021.6601
Vancouver ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study. Haseki Tıp Bülteni. 2021; 59(2): 96 - 102. 10.4274/haseki.galenos.2021.6601
IEEE ŞİMŞEK P,İLHAN E,BÜLBÜL Ö,ÜÇÜNCÜ E,TOPBAS M,GÜNDÜZ A "How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study." Haseki Tıp Bülteni, 59, ss.96 - 102, 2021. 10.4274/haseki.galenos.2021.6601
ISNAD ŞİMŞEK, Perihan vd. "How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study". Haseki Tıp Bülteni 59/2 (2021), 96-102. https://doi.org/10.4274/haseki.galenos.2021.6601