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The Impact of the COVID-19 Pandemic on Demand for Emergency Ambulances in Victoria, Australia.
Prehosp Emerg Care. 2021 Jul 16 [Online ahead of print]PE

Abstract

Objective: Relatively little has been reported about the impact of COVID-19 restrictions on emergency ambulance services. We describe the influence of the COVID-19 pandemic on the emergency ambulance system in Victoria, Australia.Methods: We performed an interrupted time series analysis of consecutive calls for ambulance from January 2018 to February 2021, including two waves of COVID-19. The COVID-19 lockdown period included seven months of stay-at-home restrictions (16/03/2020-18/10/2020). Nineteen weeks of post-lockdown data were included (19/10/2020-28/02/2021).Results: In total, 2,356,326 consecutive calls were included. COVID-19 lockdown was associated with an absolute reduction of 64,991 calls (almost 2,100 calls/week). According to time series analysis, lockdown was associated with a 12.6% reduction in weekly calls (IRR = 0.874 [95% CI 0.811, 0.941]), however no change in long-term trend (IRR = 1.000 [95% CI 0.996, 1.003]). During lockdown, the long-term trend of attendances to patients with suspected acute coronary syndromes (ACS, IRR = 1.006 [95% CI 1.004, 1.009]) and mental health-related issues (IRR = 1.005 [95% CI 1.002, 1.008]) increased. After lockdown, the call volume was 5.6% below pre-COVID-19 predictions (IRR = 0.944 [95% CI 0.909, 0.980]), however attendances for suspected ACS were higher than predicted (IRR = 1.069 [95% CI 1.009, 1.132]). Ambulance response times deteriorated, and total case times were longer than prior to the pandemic, driven predominantly by extended hospital transfer times.Conclusion: The COVID-19 pandemic had a dramatic impact on the emergency ambulance system. Despite lower call volumes post-lockdown than predicted, we observed deteriorating ambulance response times, extended case times and hospital delays. The pattern of attendance to patients with suspected ACS potentially highlights the collateral burden of delaying treatment for urgent conditions.

Authors+Show Affiliations

Received May 16, 2021 from Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Australia (EA, ZN, MS, TW, KS); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (EA, ZN, MS, KS); Department of Paramedicine, Monash University, Melbourne, Australia (ZN, MS). Revision received June 8, 2021; accepted for publication June 14, 2021.Received May 16, 2021 from Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Australia (EA, ZN, MS, TW, KS); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (EA, ZN, MS, KS); Department of Paramedicine, Monash University, Melbourne, Australia (ZN, MS). Revision received June 8, 2021; accepted for publication June 14, 2021.Received May 16, 2021 from Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Australia (EA, ZN, MS, TW, KS); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (EA, ZN, MS, KS); Department of Paramedicine, Monash University, Melbourne, Australia (ZN, MS). Revision received June 8, 2021; accepted for publication June 14, 2021.Received May 16, 2021 from Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Australia (EA, ZN, MS, TW, KS); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (EA, ZN, MS, KS); Department of Paramedicine, Monash University, Melbourne, Australia (ZN, MS). Revision received June 8, 2021; accepted for publication June 14, 2021.Received May 16, 2021 from Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Australia (EA, ZN, MS, TW, KS); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (EA, ZN, MS, KS); Department of Paramedicine, Monash University, Melbourne, Australia (ZN, MS). Revision received June 8, 2021; accepted for publication June 14, 2021.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34152925

Citation

Andrew, Emily, et al. "The Impact of the COVID-19 Pandemic On Demand for Emergency Ambulances in Victoria, Australia." Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 2021, pp. 1-7.
Andrew E, Nehme Z, Stephenson M, et al. The Impact of the COVID-19 Pandemic on Demand for Emergency Ambulances in Victoria, Australia. Prehosp Emerg Care. 2021.
Andrew, E., Nehme, Z., Stephenson, M., Walker, T., & Smith, K. (2021). The Impact of the COVID-19 Pandemic on Demand for Emergency Ambulances in Victoria, Australia. Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 1-7. https://doi.org/10.1080/10903127.2021.1944409
Andrew E, et al. The Impact of the COVID-19 Pandemic On Demand for Emergency Ambulances in Victoria, Australia. Prehosp Emerg Care. 2021 Jul 16;1-7. PubMed PMID: 34152925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of the COVID-19 Pandemic on Demand for Emergency Ambulances in Victoria, Australia. AU - Andrew,Emily, AU - Nehme,Ziad, AU - Stephenson,Michael, AU - Walker,Tony, AU - Smith,Karen, Y1 - 2021/07/16/ PY - 2021/6/22/pubmed PY - 2021/6/22/medline PY - 2021/6/21/entrez KW - COVID-19 KW - ambulance KW - demand KW - emergency medical service KW - utilization SP - 1 EP - 7 JF - Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors JO - Prehosp Emerg Care N2 - Objective: Relatively little has been reported about the impact of COVID-19 restrictions on emergency ambulance services. We describe the influence of the COVID-19 pandemic on the emergency ambulance system in Victoria, Australia.Methods: We performed an interrupted time series analysis of consecutive calls for ambulance from January 2018 to February 2021, including two waves of COVID-19. The COVID-19 lockdown period included seven months of stay-at-home restrictions (16/03/2020-18/10/2020). Nineteen weeks of post-lockdown data were included (19/10/2020-28/02/2021).Results: In total, 2,356,326 consecutive calls were included. COVID-19 lockdown was associated with an absolute reduction of 64,991 calls (almost 2,100 calls/week). According to time series analysis, lockdown was associated with a 12.6% reduction in weekly calls (IRR = 0.874 [95% CI 0.811, 0.941]), however no change in long-term trend (IRR = 1.000 [95% CI 0.996, 1.003]). During lockdown, the long-term trend of attendances to patients with suspected acute coronary syndromes (ACS, IRR = 1.006 [95% CI 1.004, 1.009]) and mental health-related issues (IRR = 1.005 [95% CI 1.002, 1.008]) increased. After lockdown, the call volume was 5.6% below pre-COVID-19 predictions (IRR = 0.944 [95% CI 0.909, 0.980]), however attendances for suspected ACS were higher than predicted (IRR = 1.069 [95% CI 1.009, 1.132]). Ambulance response times deteriorated, and total case times were longer than prior to the pandemic, driven predominantly by extended hospital transfer times.Conclusion: The COVID-19 pandemic had a dramatic impact on the emergency ambulance system. Despite lower call volumes post-lockdown than predicted, we observed deteriorating ambulance response times, extended case times and hospital delays. The pattern of attendance to patients with suspected ACS potentially highlights the collateral burden of delaying treatment for urgent conditions. SN - 1545-0066 UR - https://www.unboundmedicine.com/medline/citation/34152925/The_Impact_of_the_COVID_19_Pandemic_on_Demand_for_Emergency_Ambulances_in_Victoria_Australia_ L2 - https://www.tandfonline.com/doi/full/10.1080/10903127.2021.1944409 DB - PRIME DP - Unbound Medicine ER -
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