Effect of the COVID-19 pandemic lockdown on non-COVID-19 emergency department visits in Eastern France: Reduced risk or avoidance behavior?

Adrien Wartelle; Farah Mourad-Chehade; Farouk Yalaoui; Jan Chrusciel; David Laplanche; Stéphane Sanchez

doi:10.1016/j.puhip.2021.100109

Effect of the COVID-19 pandemic lockdown on non-COVID-19 emergency department visits in Eastern France: Reduced risk or avoidance behavior?

Public Health Pract (Oxf). 2021 Nov:2:100109. doi: 10.1016/j.puhip.2021.100109. Epub 2021 Mar 27.

Authors

Adrien Wartelle^{1

2}, Farah Mourad-Chehade¹, Farouk Yalaoui¹, Jan Chrusciel², David Laplanche², Stéphane Sanchez²

Affiliations

¹ Université Technologique de Troyes, Laboratoire Informatique et Société Numérique (LIST3N), 12 Rue Marie Curie, Troyes, F-10000, France.
² Centre Hospitalier de Troyes, Information Médicale et Evaluation des Performances (IMEP), 101 Av Anatole France, Troyes, F-10000, France.

Abstract

Objective: To study the impact of COVID-19 pandemic lockdown on avoided emergency department visits and consequent hospitalizations.

Study design: An observational retrospective design was used to investigate avoided visits and hospitalizations of an departmental emergency department combined with a clustering approach on multimorbidity patterns.

Methods: A multimorbidity clustering technique was applied on the emergency department diagnostics to segment the population in diseases clusters. Global visits and hospitalizations from an emergency department during the 2020 lockdown were put in perspective with the same period during 2019. Using a comparison with the five previous years, avoided hospitalizations per inhabitants during the lockdown were estimated for each diseases cluster.

Results: During the 8 weeks of lockdown, the number of emergency department visits have been reduced by 41.47% and resultant hospitalizations by 28.50% compared to 2019. The retrospective study showed that 14 of 17 diseases clusters had a statistically significant reduction in hospitalizations with a pronounced effect on lower acuity diagnoses and middle-aged patient, leading to 293 avoided hospitalizations per 100,000 inhabitants compared to the 5 previous years and to the 85.8 COVID-19 hospitalizations per 100,000 inhabitants.

Conclusion: Although specific to a regional context of pandemic containment, the study suggest that COVID-19 lockdown had beneficial effects on the crowding situation of the emergency departments and hospitals with avoidance effects primarily link to reduced risks.

Keywords: COVID-19; Cluster analysis; Emergency medical services; Health services administration; Retrospective studies.