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Emergency Department and COVID-19 Pandemic Stress Test: A Comparison between Two European Settings
Laura Tomaino1,2, Ilaria Roncarati1,2, Silvia Rodríguez-Mireles3,4
1Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy.
Summary
Spanish Emergency Departments (ED) saw increased activity and lower admission rates during COVID-19 lockdowns compared to Italy. Structured primary care may improve patient discharge and reduce ED burden.
Area of Science:
- Public Health
- Emergency Medicine
- Healthcare Management
Background:
- The COVID-19 pandemic and associated lockdowns significantly impacted healthcare services globally.
- Emergency Departments (EDs) experienced shifts in patient volume and acuity during this period.
- Understanding these changes is crucial for assessing healthcare system resilience and preparedness.
Purpose of the Study:
- To analyze Emergency Department (ED) activity changes in Italian and Spanish hospitals during the 2020 COVID-19 lockdown.
- To compare ED activity during lockdown periods with corresponding timeframes in 2019 and 2021.
- To investigate if enhanced primary healthcare services could mitigate COVID-19-related pressure on EDs.
Main Methods:
- A multicenter, retrospective study involving adult patients registered at selected EDs in Italy and Spain.
- Data collected for specific periods: March 9–May 3 (Italy) and March 14–May 10 (Spain) across 2019, 2020, and 2021.
- Exclusion criteria included patients under 16 and women with obstetric/gynecological complaints.
Main Results:
- The Spanish ED experienced higher patient flow (14,034 vs. 8,569 in 2019; 7,208 vs. 3,101 in 2020; 13,214 vs. 5,555 in 2021) compared to the Italian ED.
- Spanish EDs showed smaller proportional declines in patient numbers during lockdowns and lower overall admission rates (13% vs. 16.9% in 2019; 19.6% vs. 34.3% in 2020; 14.3% vs. 26.3% in 2021).
- The majority of referrals to Spanish EDs were for non-emergency conditions, followed by trauma and intoxications.
Conclusions:
- Spanish EDs demonstrated increased activity but lower hospitalization rates compared to Italian EDs during the study periods.
- Further research is needed to explore the role of structured primary healthcare in improving patient discharge rates.
- Enhanced primary care could potentially reduce the burden on Emergency Departments, especially during public health crises.
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