Trends in emergency department admissions during the COVID-19 pandemic

Abstract

Aim: In Costa Rica, a decrease in the admissions in the emergency departments were observed at the beginning of the pandemic and the objective of this study was to describe this phenomenon, its duration, as well as its implications in our country.
Methods: It is a retrospective descriptive observational study of the admissions in the Emergency Departments of the Hospitals belonging to the Costa Rican Social Security from January 1 to December 31, 2020.
Results: 25 emergency departments were included. Admissions during the study period was 1,549,024 million visits and the number of re-evaluations to 4,038,029. The range of visits in the different emergency departments were from 19,070,000 to 122,251,000 during the study period. It was observed that 850 707 (54.9%) were female. The largest number of patients treated in the emergency departments were aged between 20 to 44 years with 693,379 (44.7%) visits, followed by the group between 45 to 64 years with 328,979 (21.2%). The acuity of the patients using the Canadian triage system were classified 40% (620,449) as category 3, 39.8% (616,855) as category 4, 14% (218,124), 5.3% (82,360) as category 2 and finally 0.6% (9,206) patients as category 1. In regards of patients with the diagnosis associated with SARS CoV-2, it was observed that 88,793 were seen in the emergency departments with such diagnoses during the study period.
Conclusions: The downward trend in consultations to the emergency departments in Costa Rica reproduces the trends reported in the literature worldwide. The explanation for this phenomenon is multifactorial. There are many ""structural"" changes both in the emergency departments and in hospitalization and the Health System in general, which will most likely have to be changed definitively and as a priority. Not only for the attention of this Pandemic but with a view to future infectious events of any kind.