J Korean Med Sci.  2017 Oct;32(10):1576-1580. 10.3346/jkms.2017.32.10.1576.

The Impact of Middle East Respiratory Syndrome Outbreak on Trends in Emergency Department Utilization Patterns

• Paek SH
• Kim DK
• Lee JH
• Kwak YH

• KMID: 2400427
• DOI: http://doi.org/10.3346/jkms.2017.32.10.1576

Abstract

Changes occurred in the patterns of utilization of emergency medical services during the Middle East respiratory syndrome (MERS) outbreak. The purpose of this study was to analyze the patterns of adult and pediatric patients who visited the emergency department (ED) during the outbreak. This retrospective study was conducted by analyzing changes in the patterns of visits among adult and pediatric patients in the ED at one tertiary teaching hospital in Korea. The study was performed from June 1, 2013 to July 31, 2015. The MERS outbreak period was from June 1 to July 31, 2015, and we compared that period to the same periods in 2013 and 2014. We compared and analyzed the patients' characteristics, emergency severity index (ESI) level at the visit, cause of visit, diagnosis, final dispositions, injury/non-injury, length of stay at the ED (EDLOS), and hospitalization rate. A total of 9,107 patients visited the ED during this period. Of these patients, 2,572 (28.2%) were pediatric patients and 6,535 (71.8%) were adult patients. The most common cause of an ED visit was fever (adult patients: 21.6%, pediatric patients: 56.2%). The proportion of non-urgent visits involving an ESI level of 4 or 5 and the EDLOS decreased significantly in pediatric and adult patients in comparison to that during the past two years. This change was significant in pediatric patients. Among adult patients, the rate of injury decreased, whereas it increased among pediatric patients. During the MERS outbreak period, pediatric ED visits due to non-urgent cases decreased significantly and there were more pronounced differences in ED utilization patterns in pediatric patients than in adult patients.

Keyword

Emergency Department; MERS; Pediatric Patients; Adults

MeSH Terms

Adult
Coronavirus Infections*
Diagnosis
Emergencies*
Emergency Medical Services
Emergency Service, Hospital*
Fever
Hospitalization
Hospitals, Teaching
Humans
Korea
Length of Stay
Middle East*
Retrospective Studies

Figure

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  Fig. 1 Study population. ER = emergency room, AER = adult emergency room, PER = pediatric emergency room.

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  Fig. 2 Number of patient visits per month to the Seoul National University Hospital ED from January 2013 to December 2015. (A) Total number of AER visits. (B) Total number of PER visits, total number of ED visits shows a sharp decrease of patients during MERS outbreak in 2015. The dark shading represents MERS period (June–July). ED = emergency department, AER = adult emergency room, PER = pediatric emergency room, MERS = Middle East respiratory syndrome.

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