Impact of the first COVID-19 pandemic wave on the care and quality indicators of a hospital emergency department

Objective.

To study the impact of the first COVID-19 pandemic wave state of emergency on qualitative and quantitative indicators of demand for the services of a hospital emergency department.

Methods.

Retrospective cross-sectional analysis of all visits by adults to the department during the Spanish state of emergency. The findings were compared to those for a similar period before the pandemic. We collected data for care variables, triage levels, wait times before triage, triage times, and times to first contact with a physician, discharge diagnostic codes, revisits within 72 hours, among other information. We also analyzed demand for time-sensitive emergencies.

Results.

Demand for emergency department care decreased overall by 48.3% (95% CI, 0.48%–0.49%) while the state of emergency was in effect. The decrease was 60.7% (95% CI, 0.60%–0.61%) during phase 0 (lockdown). The decrease was more marked for the lower priority emergencies during lockdown (phase 0), at 60.5% for the lowest (level V) versus 35.1% for the highest priority (level I). The most frequent diagnoses were for respiratory conditions, followed by abdominal pain. There was a decrease in demand for treatment for all time-sensitive conditions.

Conclusions.

Overall demand for emergency care for adults fell during the first COVID-19 pandemic wave state of emergency in Spain. Lower priority emergencies for less serious problems saw the greatest decreases. We also saw a decrease in the use of time-dependent procedures.