Impacto de la pandemia de la COVID-19 en la actividad de los servicios de urgencias de atención primaria: estudio comparativo entre periodos de 2019 y 2020 / COVID-19 pandemic impact on primary care emergency services activity: Comparative study between 2019 and 2020 periods

Objetivo: Comparar la atención prestada por los servicios de urgencias de atención primaria durante el confinamiento por la COVID-19 (marzo-junio de 2020) y el mismo periodo de 2019. Diseño: Estudio descriptivo retrospectivo. Emplazamiento: Zona básica de salud de la ciudad de Granada.Participantes: Diez mil setecientos noventa registros de urgencias, 3.319 en 2020 y 7.471 en 2019. Mediciones principales: Edad, sexo, servicio, franjas horarias, derivación al alta, niveles de prioridad, tiempos de espera, procesos previos y motivos de consulta. Se emplearon la «t» de Student y Chi-cuadrado para variables continuas y categóricas. Se calcularon el tamaño del efecto (d de Cohen) y OR junto con el IC al 95%. Resultados: Las urgencias disminuyeron en 2020 con respecto a 2019, aumentó el porcentaje de las urgencias prioridad v (p<0,01), derivaciones al alta al domicilio (p=0,01) y traslados al hospital (p<0,01), en detrimento de las derivaciones a los médicos de familia (p<0,01). Aumentaron en 2020 las urgencias en horario nocturno (p<0,01) y en barrios de renta baja (p<0,01). El tiempo de espera para clasificación disminuyó (p<0,01), pero el total de asistencia aumentó en 2020 (p<0,01). Los pacientes atendidos en 2020 fueron de mayor edad (p<0,01) y con un mayor número de procesos previos (p<0,01), destacando los pacientes con ansiedad, depresión o somatizaciones (p<0,01) y diabetes (p=0,041). Aumentaron las consultas relacionadas con diversos síntomas de la COVID-19, problemas de salud mental y enfermedades crónicas. Conclusiones: Los servicios de urgencias de atención primaria ofrecen ventajas adicionales ante situaciones como la pandemia de la COVID-19, dado que permiten canalizar parte de la demanda sanitaria.(AU)

Objective: To compare the care provided by primary care emergency services during the COVID19 lockdown (March-June 2020) and the same period in 2019. Design: Retrospective descriptive study. Setting: Basic Health Area of Granada. Population: 10.790 emergency reports, 3.319 in 2020 and 7.471 in 2019. Outcomes: Age, sex, service, shifts, referrals, priority levels, care times, previous processes, and reasons for consultation. T-Student and Chi Square were used for continuous and categorical variables. Effect size (Cohen's d) and OR along with 95% CI were calculated. Results: The patients attended by primary care emergency services decreased in 2020 compared to 2019, but the percentage of Priority V cases (p<0.01), home discharges (p=0.01) and hospital transfers (p<0.01) increased, and referrals to family doctors (p<0.01) decreased. In 2020, the percentage of emergencies at night (p<0.01) and in low-income neighborhoods (p<0.01) increased. Waiting time for classification decreased (p<0.01), but total care time increased in 2020 (p<0.01). The patients seen in 2020 were older (p<.001), and with a greater number of previous processes (p<0.01), highlighting patients with anxiety, depression, or somatization (p<0.01) and diabetes (p=0.041). Consultations related to various symptoms of COVID19, mental health problems and chronic pathologies increased. Conclusions: Primary care emergency services offer additional advantages in situations such as the COVID19 pandemic, as they allow channeling part of the health demand.(AU)

[COVID-19 pandemic impact on primary care emergency services activity: Comparative study between 2019 and 2020 periods]. / Impacto de la pandemia de la COVID-19 en la actividad de los servicios de urgencias de atención primaria: estudio comparativo entre periodos de 2019 y 2020.

OBJECTIVE: To compare the care provided by primary care emergency services during the COVID19 lockdown (March-June 2020) and the same period in 2019. DESIGN: Retrospective descriptive study. SETTING: Basic Health Area of Granada. POPULATION: 10.790 emergency reports, 3.319 in 2020 and 7.471 in 2019. OUTCOMES: Age, sex, service, shifts, referrals, priority levels, care times, previous processes, and reasons for consultation. T-Student and Chi Square were used for continuous and categorical variables. Effect size (Cohen's d) and OR along with 95% CI were calculated. RESULTS: The patients attended by primary care emergency services decreased in 2020 compared to 2019, but the percentage of Priority V cases (p<0.01), home discharges (p=0.01) and hospital transfers (p<0.01) increased, and referrals to family doctors (p<0.01) decreased. In 2020, the percentage of emergencies at night (p<0.01) and in low-income neighborhoods (p<0.01) increased. Waiting time for classification decreased (p<0.01), but total care time increased in 2020 (p<0.01). The patients seen in 2020 were older (p<.001), and with a greater number of previous processes (p<0.01), highlighting patients with anxiety, depression, or somatization (p<0.01) and diabetes (p=0.041). Consultations related to various symptoms of COVID19, mental health problems and chronic pathologies increased. CONCLUSIONS: Primary care emergency services offer additional advantages in situations such as the COVID19 pandemic, as they allow channeling part of the health demand.