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During the 1st wave of CoViD-19 pandemic there was a drastic reduction in total number of accesses, with more serious cases and a exorbitant increase in crowding, due to access block.
Objectives
evaluate population who went to ED for (1) mental disorders requesting a psychiatric visit and for (2) intossication and substance abuse, between the first and second wave of the coronavirus pandemic
Methods
We enrolled all patients who went at our ED from May 1 to October 20, 2020 and during the same period of 2019. We analized: vital parameters, age, sex, exit severity codes, hospitalization rate, Crowding input factors (number of access, waiting time, priority time to doc), Crowding throughput factors (LOS: Length Of ED Stay), Crowding output factors (percentage of access block; Total Access Block Time).
Results
The results are shown in table 1
Table 1
Mental-disorder
intossication/substance-abuse
May1-October 20,2020
May1- October 20,2019
May1-October 20,2020
May1- October 20, 2019
number of ED access
543
564
182
254
higher (yellow and red) priority time to doc (%)
28%
29%
50%
39%
worse exit severity codes (%)
10%
6%
16%
11%
rate of hospitalization (%)
26%
20%
16%
9%
average waiting times (min)
60
64
76
79
LOS lenght of stay (min)
369
326
629
506
access block (%)
3%
2%
5%
4%
Total Access Block Time: examination rooms (min)
11.538
8.384
8.059
8.889
Total Access Block Time: holding area (min)
8.382
3.963
182
254
Conclusions
We would like to thank all employees of the IRCCS Policlinico San Matteo Foundation for their extraordinary efforts during the pandemic.
The 2019 coronavirus epidemic (CoViD-19) in Italy originated in Lombardy, on February 21, 2020. Crowding has been defined as a worldwide problem as cause of reduced quality of care and patient satisfaction. It is due and identified by three orders of factors: those at the access (input); those related to the patient’s process (throughput); and those at the exit from the ED (output).
Objectives
We evaluated all the population who went to ED for intossication and substance abuse. Due to the high level of care needed by these, an excessive duration of LOS (length of Stay) can be counterproductive.
Methods
We evaluated all patients accessing our ED for intossication and substance abuse from February 22 to May 1, 2020 and during the same period of the previous year.
Results
We enrolled 142 patients. The Crowding input factors are lower in the pandemic period: reduced attenders (41 vs 101) and reduced average waiting times (59 min vs 86 min). The Crowding throughput factors have instead worsened: LOS for both the visit rooms (810 vs 544 min) and the holding area (1205 min vs 947 min). The Crowding output factors also worsened: the percentage of access block is higher during the pandemic (10% vs 5%). The Total Access Block Time is significantly higher in the CoViD period for the holding area (1053 vs 930 min).
Conclusions
The pandemic period presented a worsened crowding for these patients due to the Access Block.
The 2019 coronavirus epidemic (CoViD-19) in Italy originated in Lombardy, on February 21, 2020. The Fondazione IRCCS Policlinico San Matteo di Pavia has been involved in the management of the outbreak since its beginning
Objectives
We evaluated all the population who went to the ED for intossication and substance abuse to assess the severity of cases evaluated as exit code and rate of hospitalization.
Methods
We enrolled all patients accessing our ED for intossication and substance abuse form February 22 to May 1, 2020 and during the same period of the previous year.
Results
We enrolled 142 patients. 41 in the CoViD period and 101 in 2019. The vital parameters, and sex were overlapping. patients during the pandemic were younger (38 vs 46) The priority codes for the medical examination were not different. CoViD pandemic patients have higher codes (yellow and red) for the medical examination (66% vs 59%); discharge severity codes (red) more frequently than in the reference period (2.4% vs 0.9%) and more frequently need hospitalization (26.8% vs 16.8%).
Conclusions
The epidemic has led to a reduction of accesses for intossication and substance abuse. Patients had more frequent hospitalization needs and more severe exit codes. the data may be due to the fact that during the pandemic only the most serious patients access the E.D., but also to the fact that a pandemic has contributed to destabilizing this class of fragile patients.
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