Impact of the Coronavirus Disease 2019 Pandemic on an Emergency Department Service: Experience at the Largest Tertiary Center in Taiwan

Li-Heng Tsai; Cheng-Yu Chien; Chen-Bin Chen; Chung-Hsien Chaou; Chip-Jin Ng; Mei-Yi Lo; Chen-Ken Seak; Joanna Chen-Yeen Seak; Zhong Ning Leonard Goh; Chen-June Seak

doi:10.2147/RMHP.S272234

Impact of the Coronavirus Disease 2019 Pandemic on an Emergency Department Service: Experience at the Largest Tertiary Center in Taiwan

Risk Manag Healthc Policy. 2021 Feb 22:14:771-777. doi: 10.2147/RMHP.S272234. eCollection 2021.

Authors

Li-Heng Tsai^{1

2}, Cheng-Yu Chien^{1

2

3}, Chen-Bin Chen^{1

2

4}, Chung-Hsien Chaou^{1

2}, Chip-Jin Ng^{1

2}, Mei-Yi Lo⁵, Chen-Ken Seak⁶, Joanna Chen-Yeen Seak⁶, Zhong Ning Leonard Goh⁶, Chen-June Seak^{1

2

4

7}

Affiliations

¹ Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, Taiwan.
⁴ Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.
⁵ Department of Nursing, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁶ Sarawak General Hospital, Kuching, Sarawak, Malaysia.
⁷ Center for Quality Management, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.

Abstract

Purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) is an emerging contagious pathogen that has caused community and nosocomial infections in many countries. This study aimed to evaluate the impact of Coronavirus disease 2019 (COVID-19) on emergency services of the largest medical center in Taiwan by comparing emergency department (ED) usage, turnover, and admission rates before the COVID-19 outbreak with those during the outbreak.

Materials and methods: A retrospective cohort study was conducted in the ED of the largest tertiary medical center in Taiwan. Trends of adult, non-trauma patients who visited the ED during February-April 2019 were compared with those during February-April 2020. The number of visits, their dispositions, crowding parameters, and turnover rates were analyzed. The primary outcome was the change in ED attendance between the two periods. The secondary outcomes were changes in hospital admission rates, crowding parameters, and turnover rates.

Results: During the outbreak, there were decreased non-trauma ED visits by 33.45% (p < 0.001) and proportion of Taiwan Triage and Acuity Scale (TTAS) 3 patients (p=0.02), with increased admission rates by 4.7% (p < 0.001). Crowding parameters and turnover rate showed significant improvements.

Conclusion: Comparison of periods before and during the COVID-19 outbreak showed an obvious decline in adult, non-trauma ED visits. The reduction in TTAS 3 patient visits and the increased hospital admission rates provide references for future public-health policy-making to optimise emergency medical resource allocations globally.

Keywords: Coronavirus disease 2019; SPOT; Stratification to Prevent Overcrowding Taskforce; Taiwan Triage and Acuity Scale; emergency department.

Grants and funding

This study was supported by the Ministry of Science and Technology of Taiwan [MOST 109-2314-B-182A-102-] and Chang Gung Memorial Hospital in Taiwan [CORPG3H0231, CORPG3H0191, CPRPG3D0012, and CMRPG3J1721] awarded to Chen-June Seak. The funder had no role in design of the study and collection, analysis, interpretation of data, and in writing the manuscript.