Abstract
The aim of this study is to reveal the impact of the COVID-19 pandemic, which constitutes an extraordinary situation, on the habits of emergency health service use. The data of the study consist of emergency service applications of a public hospital in Turkey between the years 2018–2021. The number of applications to the emergency service was examined periodically. The interrupted time series analysis method was used to reveal the impact of the COVID-19 outbreak on emergency service admissions. When the main findings are analyzed in quarterly periods (3 months = 1 quarter); there has been a sharp decrease in emergency service applications since March 2019, when the first case was seen in Turkey. When an evaluation is made between consecutive quarters, it is seen that there are fluctuations up to 80% in the number of applications. When the statistical analysis findings are examined; while the effect of COVID-19 on the number of applications was found to be significant for the first four periods, it was found to be insignificant for the following periods. With the conducted study, it was revealed that COVID-19 has a significant impact on the use of emergency health services. Although there was a statistically significant decrease in the number of applications, especially in the months following the first case, there was an increase in the number of applications over time. Considering the necessity of using emergency health services when necessary, it can be thought that some of the decrease in the number of applications during the COVID-19 period will be related to the use of unnecessary emergency health services.
Similar content being viewed by others
Data availability
The datasets generated during and/or analyzed during the current study are not publicly available due [REASON WHY DATA ARE NOT PUBLIC] but are available from the corresponding author on reasonable request.
References
Wongtanasarasin W, Srisawang T, Yothiya W, Phinyo P (2021) Impact of national lockdown towards emergency department visits and admission rates during the COVID-19 pandemic in Thailand: a hospital-based study. Emerg Med Australas 33(2):316–323. https://doi.org/10.1111/1742-6723.13666
Aslan EÇ, Orhan M (2022) COVID-19 Pandemisinin Hastanelerin Vaka Karma İndeksine Etkisinin Değerlendirilmesi: Tanımlayıcı Bir Araştırma. Turkiye Klinikleri J Health Sci 7(3):888–898. https://doi.org/10.5336/healthsci.2021-87432
Geçkalan D, Özdemir R (2022) Did the COVID-19 pandemic affect the emergency service and outpatient clinic applications of pediatric patients? Safety 3:7. https://doi.org/10.4274/cayd.galenos.2022.44227
Adaş G, Sarvan F, Küpelioğlu R, Taviloğlu K (1997) İstanbul İlinde Bulunan Farklı Statüdeki Üç Eğitim Hastanesinin Acil ve Kaza Servislerinin Değerlendirilmesi. Ulus Travma ve Acil Cerrahi Derg 3(3):222–227
Santana R, Sousa JS, Soares P, Lopes S, Boto P, Rocha JV (2020) The demand for hospital emergency services: trends during the first month of COVID-19 response. Port J Public Health 38(1):30–36. https://doi.org/10.1159/000507764
Perlini S, Canevari F, Cortesi S, Sgromo V, Brancaglione A, Contri E et al (2020) Emergency department and out-of-hospital emergency system (112—AREU 118) integrated response to coronavirus disease 2019 in a Northern Italy centre. Intern Emerg Med 15(5):825–833. https://doi.org/10.1007/s11739-020-02390-4
Hawton K, Bergen H, Simkin S, Brock A, Griffiths C, Romeri E et al (2009) Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. BMJ. https://doi.org/10.1136/bmj.b2270
Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D (2002) Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther 27(4):299–309. https://doi.org/10.1046/j.1365-2710.2002.00430.x
Bernal JL, Cummins S, Gasparrini A (2017) Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol 46(1):348–355. https://doi.org/10.1093/ije/dyw098
Bernal JL, Cummins S, Gasparrini A (2018) The use of controls in interrupted time series studies of public health interventions. Int J Epidemiol 47(6):2082–2093. https://doi.org/10.1093/ije/dyy135
Çıraklı Ü (2018) 2009 Ekonomik Krizinin ve 2007 Yılı Mevzuat Değişikliğinin Türkiye’de Katastrofik Sağlık Harcaması Yapan Hane Oranı Üzerine Etkisi. Soc Sci Stud J 4(22):3862–3869
WHO (2022) Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed 14 May 2023
Pignon B, Gourevitch R, Tebeka S, Dubertret C, Cardot H, Dauriac-Le Masson V et al (2020) Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID-19 in Paris and suburbs. medRxiv. https://doi.org/10.1111/pcn.13104
Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J et al (2020) Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. Morb Mortal Wkly Rep 69(23):699. https://doi.org/10.15585/mmwr.mm6923e1
Raucci U, Musolino AM, Di Lallo D, Piga S, Barbieri MA, Pisani M et al (2021) Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children’s hospital. Ital J Pediatr 47(1):1–12. https://doi.org/10.1186/s13052-021-00976-y
Sanmarchi F, Golinelli D, Lenzi J, Grilli R, Fantini M, Gori D (2022) The impact of the COVID-19 pandemic on the use of Emergency Departments in Italy. Ann Igiene Med Prev Comunita. https://doi.org/10.7416/ai.2022.2548
Demir G, Berksoy E, Bardak Ş, Elibol P, Çiçek A, Nalbant T et al (2022) The Effects of the COVID-19 Pandemic on Emergency Patient Profiles: A Case Study of a Turkish Tertiary Care Pediatric Emergency and Trauma Center. South Clin Istanb Eurasia. https://doi.org/10.14744/scie.2021.89804
Angulvant F, Quldali N, Yong D (2020) Covid-19 pandemic: impact caused by school closure and national lockdown on pediatric visits and admissions for viral and non-viral infections, a time series analysis. Clin Infect Dis Jun. https://doi.org/10.1093/cid/ciaa710
Civaner M (1999) Bir devlet hastanesinin acil servisine başvuran hastaların analizi. Sağlık ve Toplum 9(1):3–7
Edirne T, Edirne Y, Atmaca B, Keskin S (2008) Yüzüncü yıl üniversitesi tıp fakültesi acil servis hastalarının özellikleri. Van Tıp Dergisi 15(4):107–111
Sert ET, Mutlu H, Kokulu K, Yeşildağ K, Sarıtaş A (2021) Acil Servisimize Başvuran Hastaların 5 Yıllık Analizi. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi. 8(1):1–4. https://doi.org/10.47572/muskutd.794039
Gürsoy A, Gunduz A, Tatli O, Şimşek B, Topbas M (2018) Evaluation of frequency, causes of inappropriate attendance to the emergency departments and relationship to overcrowding in Trabzon Province. TUBITAK 3001-Starting R&D Projects Support Program, No: 216S973
Simsek P, Ilhan E, Bülbül Ö, Üçüncü E, Topbaş M, Gündüz A (2021) How did the COVID-19 pandemic affect inappropriate adult emergency department attendances? A prospective cross-sectional study. Haseki Tip Bull Med Bull Haseki. https://doi.org/10.4274/haseki.galenos.2021.6601
Carret MLV, Fassa ACG, Domingues MR (2009) Inappropriate use of emergency services: a systematic review of prevalence and associated factors. Cad Saude Publica 25:7–28. https://doi.org/10.1590/s0102-311x2009000100002
O’Cathain A, Connell J, Long J, Coster J (2020) ‘Clinically unnecessary’use of emergency and urgent care: a realist review of patients’ decision making. Health Expect 23(1):19–40. https://doi.org/10.1111/hex.12995
Şimşek P, Gürsoy A (2016) Turkish health care providers’ views on inappropriate use of emergency department: who, when and why? Int Emerg Nurs 27:31–36. https://doi.org/10.1016/j.ienj.2015.11.004
Acknowledgements
There is no funding to report for this submission.
Author information
Authors and Affiliations
Contributions
All authors have contributed to the conceptual design of the study, writing the search strategies, data extraction, data interpretation, and manuscript preparation.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest
Ethics statement
This study was approved by the Izmir Bakırçay University Non-Interventional Ethics Committee. The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Human and animal rights statement and Informed consent
The study was performed in accordance with the ethical principles of the Declaration of Helsinki and with the International Conference on Harmonization Good Clinical Practice guidelines.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Çirakli, Ü., Orhan, M., Sayar, B. et al. Impact of COVID-19 on emergency service usage in Turkey: interrupted time series analysis. Intern Emerg Med 18, 2105–2112 (2023). https://doi.org/10.1007/s11739-023-03344-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11739-023-03344-2