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Pattern of Emergency Department referral during the COVID-19 outbreak in Italy.
Bellan, Mattia; Gavelli, Francesco; Hayden, Eyal; Patrucco, Filippo; Soddu, Daniele; Pedrinelli, Anita R; Cittone, Micol G; Rizzi, Eleonora; Casciaro, Giuseppe F; Vassia, Veronica; Landi, Raffaella; Menegatti, Mirta; Gastaldello, Maria L; Beltrame, Michela; Labella, Emanuela; Tonello, Stelvio; Avanzi, Gian C; Pirisi, Mario; Castello, Luigi M; Sainaghi, Pier P.
  • Bellan M; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy - mattia.bellan@uniupo.it.
  • Gavelli F; CAAD, Center for Autoimmune and Allergic Diseases, Novara, Italy - mattia.bellan@uniupo.it.
  • Hayden E; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy - mattia.bellan@uniupo.it.
  • Patrucco F; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Soddu D; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Pedrinelli AR; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Cittone MG; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Rizzi E; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Casciaro GF; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Vassia V; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Landi R; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Menegatti M; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Gastaldello ML; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Beltrame M; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Labella E; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Tonello S; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Avanzi GC; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Pirisi M; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
  • Castello LM; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Sainaghi PP; Division of Internal and Emergency Medicine, Maggiore della Carità University Hospital, Novara, Italy.
Panminerva Med ; 63(4): 478-481, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1591662
ABSTRACT

BACKGROUND:

The Coronavirus disease (COVID-19) outbreak is putting the European National Health Systems under pressure. Interestingly, Emergency Department (ED) referrals for other reasons than COVID-19 seem to have declined steeply. In the present paper, we aimed to verify how the COVID-19 outbreak changed ED referral pattern.

METHODS:

We retrospectively reviewed the clinical records of patients referred to the ED of a University Hospital in Northern Italy from 1 March to 13 April 2020. We compared the following data with those belonging to the same period in 2019 number of EDs accesses, rate of hospital admission, frequencies of the most common causes of ED referral, priority codes of access.

RESULTS:

The number of ED referrals during the COVID-19 outbreak was markedly reduced when compared to the same period in 2019 (3059 vs. 5691; -46.3%). Conversely, the rate of hospital admission raised from 16.9% to 35.4% (P<0.0001), with a shift toward higher priority codes of ED admission. In 2020, we observed both a reduction of the number of patients referred for both traumatic (513, 16.8% vs. 1544, 27.1%; χ2=118.7, P<0.0001) and non-traumatic (4147 vs. 2546) conditions. Among the latter, suspected COVID-19 accounted for 1101 (43.2%) accesses.

CONCLUSIONS:

The COVID-19 pandemic completely changed the pattern of ED referral in Italy, with a marked reduction of the accesses to the hospitals. This could be related to a limited exposure to traumas and to a common fear of being infected during EDs in-stay. This may limit the misuse of EDs for non-urgent conditions but may also delay proper referrals for urgent conditions.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Referral and Consultation / Disease Outbreaks / Emergency Service, Hospital / COVID-19 Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Panminerva Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Referral and Consultation / Disease Outbreaks / Emergency Service, Hospital / COVID-19 Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Panminerva Med Year: 2021 Document Type: Article