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Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021

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 c...

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Autores principales: Schranz, Madlen, Boender, T. Sonia, Greiner, Timo, Kocher, Theresa, Wagner, Birte, Greiner, Felix, Bienzeisler, Jonas, Diercke, Michaela, Grabenhenrich, Linus, Aigner, Annette, Ullrich, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152015/
https://www.ncbi.nlm.nih.gov/pubmed/37131165
http://dx.doi.org/10.1186/s12889-023-15375-7
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author Schranz, Madlen
Boender, T. Sonia
Greiner, Timo
Kocher, Theresa
Wagner, Birte
Greiner, Felix
Bienzeisler, Jonas
Diercke, Michaela
Grabenhenrich, Linus
Aigner, Annette
Ullrich, Alexander
author_facet Schranz, Madlen
Boender, T. Sonia
Greiner, Timo
Kocher, Theresa
Wagner, Birte
Greiner, Felix
Bienzeisler, Jonas
Diercke, Michaela
Grabenhenrich, Linus
Aigner, Annette
Ullrich, Alexander
author_sort Schranz, Madlen
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-15375-7.
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spelling pubmed-101520152023-05-03 Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021 Schranz, Madlen Boender, T. Sonia Greiner, Timo Kocher, Theresa Wagner, Birte Greiner, Felix Bienzeisler, Jonas Diercke, Michaela Grabenhenrich, Linus Aigner, Annette Ullrich, Alexander BMC Public Health Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-15375-7. BioMed Central 2023-05-02 /pmc/articles/PMC10152015/ /pubmed/37131165 http://dx.doi.org/10.1186/s12889-023-15375-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Schranz, Madlen
Boender, T. Sonia
Greiner, Timo
Kocher, Theresa
Wagner, Birte
Greiner, Felix
Bienzeisler, Jonas
Diercke, Michaela
Grabenhenrich, Linus
Aigner, Annette
Ullrich, Alexander
Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title_full Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title_fullStr Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title_full_unstemmed Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title_short Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021
title_sort changes in emergency department utilisation in germany before and during different phases of the covid-19 pandemic, using data from a national surveillance system up to june 2021
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152015/
https://www.ncbi.nlm.nih.gov/pubmed/37131165
http://dx.doi.org/10.1186/s12889-023-15375-7
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