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Effect of the SARS outbreak on visits to a community hospital emergency department

Published online by Cambridge University Press:  21 May 2015

Michael Heiber*
Affiliation:
Department of Family and Community Medicine, Scarborough Hospital, Toronto, Ont
W.Y. Wendy Lou
Affiliation:
Department of Public Health Sciences, University of Toronto, Toronto, Ont
*
Scarborough Hospital, 3050 Lawrence Ave. E, Toronto ON M1P 2V5

Abstract

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Objectives:

To examine the effect of severe acute respiratory syndrome (SARS) on visits to a community hospital emergency department (ED) during the early stage of the Toronto outbreak in 2003 and for the same period in 2004. We focused on visits for respiratory illness (SARS-like symptoms) and different age groups.

Methods:

This study is a retrospective review of ED discharge diagnoses obtained from a computerized database, examining the 4-week period starting March 28 for the years 2001-2004. We obtained the discharge diagnosis, age and visit date for each ED patient during the relevant time intervals, then compared visit data from 2003 and 2004 with a baseline derived from the average number of visits during 2001 and 2002. We constructed groupings based on age and respiratory-illness symptoms.

Results:

During the SARS outbreak in 2003, ED visits declined by 21% (95% confidence interval [CI], 18%–24%) over the 4-week study period. The greatest reduction was for combined infant and toddler visits (69%; 95% CI, 58%–79%); these did not recover the following year. However, during the SARS outbreak there was a large increase in the number of visits for respiratory illnesses in adults (61%; 95% CI, 46%–75%) and in teenagers (132%; 95% CI, 82%–182%).

Conclusions:

During the SARS outbreak, total ED visits fell. The relative decline was most notable for infants and toddlers. By contrast, there was an increase in respiratory illness–related visits for adults and teenagers. In 2004, the year following the SARS outbreak, visit patterns shifted toward baseline levels, but ED visits by infants and toddlers remained depressed.

Type
Original Research • Recherche originale
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Brillman, JC, Sklar, DP, Davis, KD, et al. Hantavirus: emergency department response to a disaster from an emerging pathogen. Ann Emerg Med 1994;24:429–36.CrossRefGoogle ScholarPubMed
2.Del Beccaro, MA, Brownstein, DR, Cummings, P, et al. Outbreak of Escherichia coli 0157:H7 hemorrhagic colitis and hemolytic uremic syndrome: effect on use of a pediatric emergency department. Ann Emerg Med 1995;26:598603.CrossRefGoogle Scholar
3.Man, CY, Yeung, RSD, Chung, JYM, et al. Impact of SARS on an emergency department in Hong Kong. Emerg Med (Fremantle) 2003;15:418–22.CrossRefGoogle Scholar
4.Chen, TA, Lai, KH, Chang, HT. Impact of a severe acute respiratory syndrome outbreak in the emergency department: an experience in Taiwan. Emerg Med J 2004;21:660–2.CrossRefGoogle ScholarPubMed
5.Chen, WK, Cheng, YC, Chung, YT, et al. The impact of the SARS outbreak on an urban emergency department in Taiwan. Med Care 2005;43:168–72.CrossRefGoogle Scholar
6.Boutis, K, Stephens, D, Lam, K, et al. The impact of SARS on a tertiary care pediatric emergency department. CMAJ 2004;171:1353–8.CrossRefGoogle ScholarPubMed
7.Beveridge, R, Clarke, B, Janes, L, et al. Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. Can J Emerg Med 1999;1(3 suppl). Online version available at: http://www.caep.ca (accessed 24 July 2006).Google Scholar
8.Johnston, SC, Sorel, ME, Sidney, S. Effects of the September 11th attacks on urgent and emergent medical evaluations in a northern California managed care plan. Am J Med 2002;113:556–62.CrossRefGoogle Scholar
9.Geehr, EC, Salluzzo, R, Bosco, S, et al. Emergency health impact of a severe storm. Am J Emerg Med 1989;7:598604.CrossRefGoogle ScholarPubMed
10.Brewer, RD, Morris, PD, Cole, TB. Hurricane-related emergency department visits in an inland area: an analysis of the public health impact of Hurricane Hugo in North Carolina. Ann Emerg Med 1994;23:731–41.CrossRefGoogle Scholar
11.Katsouyanni, K, Kogevinas, M, Trichopoulos, D. Earthquake-related stress and cardiac mortality. Int J Epidemiol 1986;15:326–9.CrossRefGoogle ScholarPubMed
12.Abraham, C. Battle against mystery ailment widens. Globe and Mail [Toronto] 2003 Mar 26;Sect A:1.Google Scholar
13.Green, S. Bug baffles medics: killer pneumonia’s cause may never be found. Toronto Sun 2003 Mar 18; p. 10.Google Scholar
14.Talada, T, Powell, B. Mystery illness threatens hospitals. Toronto Star 2003 Mar 28; Sect A: 1.Google Scholar