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Changes in Emergency Department Case Severity and Length of Stay before and after COVID-19 Outbreak in Korea

Yong-Seok Kim1, In-Byung Kim2, Seon-Rye Kim3

  • 1Department of Emergency Medical Service, College of Medical Science, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea.

Healthcare (Basel, Switzerland)
|August 26, 2022
PubMed

Insights

The COVID-19 pandemic saw fewer emergency room visits overall, but severely ill patients experienced longer stays. Ambulance use and the proportion of severe cases increased, highlighting the need for pandemic-ready emergency department strategies.

Area of Science:

  • Emergency Medicine
  • Public Health
  • Infectious Disease Epidemiology

Background:

  • The COVID-19 pandemic significantly altered healthcare utilization patterns.
  • Emergency departments (EDs) faced unprecedented challenges in patient management and resource allocation.
  • Understanding changes in patient characteristics and ED workflow during the pandemic is crucial for future preparedness.

Purpose of the Study:

  • To compare patient demographics, severity, and ED length of stay (LOS) before and after the COVID-19 outbreak.
  • To analyze the impact of the pandemic on ED operational efficiency and patient disposition.
  • To identify key trends in emergency care during a public health crisis.

Main Methods:

  • Retrospective analysis of 75,409 ED visits from February 1, 2019, to January 19, 2021.
  • Comparison of patient data from pre-COVID-19 (Feb 2019-Jan 2020) and COVID-19 (Feb 2020-Jan 2021) periods.
  • Statistical analysis using chi-square tests, t-tests, and Cramer V for correlation (p < 0.05).

Main Results:

  • Overall ED visits decreased by 37.6% post-COVID-19.
  • ED length of stay for severely ill patients increased by 203.7%.
  • Ambulance utilization rose by 9.0%, with a 2.1% increase in the proportion of severe cases.

Conclusions:

  • The COVID-19 pandemic led to a paradoxical increase in ED LOS for severe cases despite fewer overall visits.
  • Higher ambulance use and a greater proportion of severe patients underscore the strain on emergency services.
  • Recommendations include developing adaptable ED designs and operational plans for both routine and pandemic scenarios.

Keywords:
COVID-19emergency department length of stayemergency medical systemseverity

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