The effect of a terrorist attack on emergency department inflow: an observation study using difference-in-differences...

Area of Science:

• Public Health
• Emergency Medicine
• Societal Impact of Terrorism

Background:

• Terrorist attacks can disrupt public services, including healthcare access.
• Understanding the impact on emergency departments (EDs) is crucial for preparedness.

Purpose of the Study:

• To investigate the effect of the 2017 Stockholm terrorist attack on patient inflow to nearby general emergency departments (EDs).
• To quantify the extent and duration of the impact on ED visits following the attack.

Main Methods:

• Retrospective observational study analyzing anonymized aggregated data on ED arrivals in Stockholm County.
• Utilized the Difference-in-Differences (DiD) estimator, comparing affected hospitals to pre-attack periods.
• Data sourced from the Stockholm County Council administrative database.

Main Results:

• A statistically significant reduction of 7-9% in overall ED inflow was observed post-attack.
• The impact was most pronounced initially, with inflow normalizing within approximately three weeks.
• The reduction in ED visits decreased with distance, becoming non-significant beyond 10 km from the attack site.

Conclusions:

• The Stockholm terrorist attack led to a significant decrease in ED inflow in the immediate weeks following the event.
• The study suggests patients may alter their decisions regarding seeking emergency care in response to such events.
• Further research is needed to fully elucidate the reasons behind this behavioral shift.