Observational studyThe western journal of emergency medicine2021
The Impact of COVID-19 on a Large, Canadian Community Emergency Department.
Observational study in The western journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- COVID-19 and Emergency Department Visits: An Interrupted Time Series Analysis of Ontario and Alberta, Canada.The western journal of emergency medicine · 2026Article
- Article
- The relationship between COVID-19 and opioid-related emergency department visits in Alberta, Canada: an interrupted time series analysis.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2025Article
- Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review.BMC emergency medicine · 2024Article
- Article
- The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan.BMC geriatrics · 2023Article
- Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department.Clinical and experimental emergency medicine · 2023Article
- Primary care utilization for patients with newly diagnosed cancer during the COVID-19 pandemic: a population-based study.BMC cancer · 2022Article
- Changes in Emergency Department Case Severity and Length of Stay before and after COVID-19 Outbreak in Korea.Healthcare (Basel, Switzerland) · 2022Article
- Observational
- A blueprint for building an emergency department quality improvement and patient safety committee.CJEM · 2022Article
- Flattening the other curve: Reducing emergency department STEMI delays during the COVID-19 pandemic.The American journal of emergency medicine · 2021Article
- Article
- Learning From a Regional Approach: Integration to Scale, Spread, and Sustain Virtual Urgent Care.Inquiry : a journal of medical care organization, provision and financingArticle
- Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs the COVID-19 pandemic unfolded, emergency departments (EDs) across the world braced for surges in volume and demand. However, many EDs experienced decreased demand even for higher acuity illnesses. In this study we sought to examine the change in utilization at a large Canadian community ED, including changes in patient demographics and presentations, as well as structural and administrative changes made in response to the pandemic.
methodsThis retrospective observational study took place in Ontario, Canada, from March 17-June 30, 2020, during province-wide lockdowns in response to COVID-19. We used a control period of March 17-June 30 in 2018-2019. Differences between observed and expected values were calculated for total visits, Canadian Triage and Acuity Scale (CTAS) groups, and age groups using Fisher's exact test. Length of stay (LOS), physician initial assessment time (PIA), and top primary and admission diagnoses were also examined.
resultsPatient visits fell to 66.3% of expected volume in the exposure period (20,901 vs 31,525, P<0.0001). CTAS-1 (highest acuity) patient volumes dropped to 86.8% of expected (P = 0.1964) while CTAS-5 (lowest acuity) patient volumes dropped to 32.4% of expected (P <0.0001). Youth (0-17), adult (18-64), and senior (65+) visits all decreased to 37.4%, 71.7%, and 72.9% of expected volumes, respectively (P <0.0001). Median PIA and median ED LOS both decreased (1.1 to 0.6 hours and 3.3 to 3.0 hours, respectively). The most common primary diagnosis in both periods was "other chest pain." Viral syndromes were more prevalent in the exposure period. The top admission diagnoses were congestive heart failure in the control period (4.8%) and COVID-19 in the study period (3.5%).
conclusionED utilization changed drastically during COVID-19. Our ED responded with wide stakeholder engagement, spatial reorganization, and human resources changes informed by real-time data. Our experiences can help prepare for potential subsequent "waves" of COVID-19 and future pandemics.
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