The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center

Abstract Background The Covid-19 pandemic began in Israel on February 2020. Between February and October 2020, 2 periods of lockdown were imposed on Israeli population. Objective To assess the effect of the Covid-19 pandemic on visits to the emergency department (ED) and on hospitalizations in medic...

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Autores principales:	Yael Frenkel Nir, Yuval Levy, Amit Gutkind, Ehud Grossman
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Covid-19 Medical wards Emergency Department Hospital admissions Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/0de36d35adc04c5fb056ec8d55495ccd
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spelling	oai:doaj.org-article:0de36d35adc04c5fb056ec8d55495ccd2021-11-07T12:13:57ZThe effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center10.1186/s13584-021-00495-52045-4015https://doaj.org/article/0de36d35adc04c5fb056ec8d55495ccd2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13584-021-00495-5https://doaj.org/toc/2045-4015Abstract Background The Covid-19 pandemic began in Israel on February 2020. Between February and October 2020, 2 periods of lockdown were imposed on Israeli population. Objective To assess the effect of the Covid-19 pandemic on visits to the emergency department (ED) and on hospitalizations in medical wards in Israel’s Chaim Sheba Medical Center, and to compare the effect during the first and second lockdowns. Methods Data regarding the number of visits of non-Covid-19 patients to the ED and the number of admissions to the medical wards, were extracted from the computerized system of the hospital. Data were analyzed for patients' characteristics, length of stay in the medical wards, in hospital mortality and the rate of 7 and 30 days re-hospitalization, and compared to the same period during 2019. Results Total visits to the Sheba ED during March-October decreased by 18.5%. The most dramatic decrease occurred during the first lockdown. The number of patients admitted to the Sheba medical wards decreased by 28% (P < 0.05). The length of stay decreased from 3.69 days during 2019 to 3.42 days during 2020 (P < 0.01). The most pronounced decrease in the length of stay was observed during the second month of the first lockdown. During the pandemic, hospitalized patients at Sheba were older and were less likely to be males. The in-hospital absolute non-COVID mortality decreased from 913 to 858 respectively. Conclusions The Covid-19 crisis emphasizes the role of medical wards in the care of complex patients. Medical wards in Israel were at the frontline of Israel's battle against this pandemic, while continuing to treat very complex non-Covid patients. To avoid burnout of the medical staff who treat very intensively complex patients, we believe these wards should be strengthen with specialists having expertise in treating these patients. Due to our insights, the Sheba medical Center is now redesigning the concept of how intensive care beds should be managed in a big tertiary center.Yael Frenkel NirYuval LevyAmit GutkindEhud GrossmanBMCarticleCovid-19Medical wardsEmergency DepartmentHospital admissionsMedicine (General)R5-920Public aspects of medicineRA1-1270ENIsrael Journal of Health Policy Research, Vol 10, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Covid-19 Medical wards Emergency Department Hospital admissions Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	Covid-19 Medical wards Emergency Department Hospital admissions Medicine (General) R5-920 Public aspects of medicine RA1-1270 Yael Frenkel Nir Yuval Levy Amit Gutkind Ehud Grossman The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
description	Abstract Background The Covid-19 pandemic began in Israel on February 2020. Between February and October 2020, 2 periods of lockdown were imposed on Israeli population. Objective To assess the effect of the Covid-19 pandemic on visits to the emergency department (ED) and on hospitalizations in medical wards in Israel’s Chaim Sheba Medical Center, and to compare the effect during the first and second lockdowns. Methods Data regarding the number of visits of non-Covid-19 patients to the ED and the number of admissions to the medical wards, were extracted from the computerized system of the hospital. Data were analyzed for patients' characteristics, length of stay in the medical wards, in hospital mortality and the rate of 7 and 30 days re-hospitalization, and compared to the same period during 2019. Results Total visits to the Sheba ED during March-October decreased by 18.5%. The most dramatic decrease occurred during the first lockdown. The number of patients admitted to the Sheba medical wards decreased by 28% (P < 0.05). The length of stay decreased from 3.69 days during 2019 to 3.42 days during 2020 (P < 0.01). The most pronounced decrease in the length of stay was observed during the second month of the first lockdown. During the pandemic, hospitalized patients at Sheba were older and were less likely to be males. The in-hospital absolute non-COVID mortality decreased from 913 to 858 respectively. Conclusions The Covid-19 crisis emphasizes the role of medical wards in the care of complex patients. Medical wards in Israel were at the frontline of Israel's battle against this pandemic, while continuing to treat very complex non-Covid patients. To avoid burnout of the medical staff who treat very intensively complex patients, we believe these wards should be strengthen with specialists having expertise in treating these patients. Due to our insights, the Sheba medical Center is now redesigning the concept of how intensive care beds should be managed in a big tertiary center.
format	article
author	Yael Frenkel Nir Yuval Levy Amit Gutkind Ehud Grossman
author_facet	Yael Frenkel Nir Yuval Levy Amit Gutkind Ehud Grossman
author_sort	Yael Frenkel Nir
title	The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
title_short	The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
title_full	The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
title_fullStr	The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
title_full_unstemmed	The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center
title_sort	effect of the covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an israeli medical center
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0de36d35adc04c5fb056ec8d55495ccd
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The effect of the Covid-19 pandemic on patient visits to the emergency department and hospitalizations in medical wards in an Israeli medical center

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