J Korean Soc Emerg Med.  2024 Dec;35(6):413-423.

Impact of COVID-19 pandemic on emergency department visits during daytime and nighttime

• Kim AY
• Yoon YH
• Kim JY
• Shim B
• Park SJ

Abstract

Objective
There has been a rapid increase in the utilization of emergency departments (EDs), especially for non-emergent cases. The challenges of accessing medical services at night cause disparities in ED utilization between the day and night. Additionally, the coronavirus disease-2019 (COVID-19) pandemic has had a notable impact on ED visits. This study aimed to compare the characteristics of patients visiting the EDs in the daytime and at night before and after COVID-19.
Methods
A retrospective observational study was conducted on adults (≥18 years) at three metropolitan EDs from January 1, 2019 to December 31, 2020. Data, including the Korean Triage Acuity System, Tenth Revision (ICD-10) codes, and ICU admissions, were collected. Characteristics of patients visiting the ED during the day (06:00-18:00) and night (18:00-06:00) periods before and after COVID-19 were analyzed.
Results
During the pre-COVID-19 and COVID-19 periods, 117,896 and 92,915 patients visited the ED, respectively. Non-emergency nighttime visits were increased than daytime visits during both the pre-COVID-19 period (37.9% vs. 30.9%) and the COVID-19 period (35.4% vs. 28.8%) (P<0.01). During COVID-19, non-emergency patient visits to the ED during the nighttime decreased compared to those during the day (odds ratio, 0.96; 95% confidence interval [CI], 0.93-0.99, P=0.01). Among the top five diagnoses, the number of patients declined during the COVID-19 pandemic in most categories, except for the category of “Fever of other and unknown origin,” which saw an increase both during the day (incident rate ratio [IRR], 1.10; 95% CI, 1.05-1.17) and night (IRR, 1.23; 95% CI, 1.17-1.30).
Conclusion
The COVID-19 pandemic significantly influenced ED visit patterns, particularly by reducing non-emergent visits during nighttime.

Keyword

Hospital emergency service; Emergency room visits; COVID-19