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Patients with Musculoskeletal Disorders Presenting to the Emergency Department: The COVID-19 Lesson

Author

Listed:
  • Gianluigi Pasta

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Alberto Polizzi

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Salvatore Annunziata

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Catherine Klersy

    (Unit of Clinical Epidemiology and Biometry, IRCCS Fondazione Policlinico San Matteo Foundation, 27100 Pavia, Italy)

  • Lorenzo Fenech

    (Centre for Research in Health and Social Care Management (CERGAS), SDA Bocconi, 20136 Milan, Italy)

  • Mohammad Reza Dermenaki Farahani

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Matteo Ghiara

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Alberto Castelli

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Eugenio Jannelli

    (Multidisciplinary Department of Medico-Surgical and Dentistry Specialties, Luigi Vanvitelli, University of Campania, 80138 Naples, Italy)

  • Federico Alberto Grassi

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

  • Mario Mosconi

    (Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy)

Abstract

Background: Musculoskeletal disorders (MSKDs) are the most common class of complaints among patients presenting for care in the Emergency Department (ED). There is a non-urgent patient population with musculoskeletal complaints attending ED services that creates a burgeoning waiting list and contributes to overcrowding in Emergency Departments (EDs), which is a major concern worldwide. The recent (Coronavirus disease-19) COVID-19 pandemic is an unprecedented challenge that is revealing the structural and situational strengths and weaknesses of healthcare systems. Methods: This study retrospectively and prospectively assessed patients presenting to the Emergency Department before and after the COVID-19 outbreak (from 21 February 2019 to 3 May 2019 and from 21 February 2020 to 3 May 2020) with non-traumatic or low-severity musculoskeletal conditions to test the hypothesis that these patients should have access to care outside the ED and that the COVID-19 outbreak has changed patients’ care and health perception. Results: A total of 613 patients were identified, and 542 of them (87.56%) participated in a personalized survey. From this number, 81.73% of the total accesses took place in 2019, and only 18.27% of the accesses took place during the first outbreak and lockdown. More than 90% of patients admitted to the ED accessed care during the day shift in both periods. A total of 87.30% of patients presenting to the ED with a MSKD followed their general practitioner’s (GP) advice/referral in 2019, and 73.87% did so in 2020. The differences in the means of transport to the ED was statistically significant ( p -value 0.002). Conclusions: The outbreak and lockdown period confirmed that there is an inappropriate use of the ED related to patients with MSKD. However, the ED appears to be the only available solution for these patients. New services and pathways are therefore needed to enhance MSKD management and reduce ED crowding. Additional observational studies shall be developed to confirm and compare our findings with those of various EDs. The main limit of the inferential part of the study is probably due to the small sample of patients in 2020.

Suggested Citation

  • Gianluigi Pasta & Alberto Polizzi & Salvatore Annunziata & Catherine Klersy & Lorenzo Fenech & Mohammad Reza Dermenaki Farahani & Matteo Ghiara & Alberto Castelli & Eugenio Jannelli & Federico Alberto, 2022. "Patients with Musculoskeletal Disorders Presenting to the Emergency Department: The COVID-19 Lesson," IJERPH, MDPI, vol. 19(10), pages 1-10, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:10:p:5891-:d:814091
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    References listed on IDEAS

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    1. Garrafa, Emirena & Levaggi, Rosella & Miniaci, Raffaele & Paolillo, Ciro, 2020. "When fear backfires: Emergency department accesses during the Covid-19 pandemic," Health Policy, Elsevier, vol. 124(12), pages 1333-1339.
    2. Enrique Casalino & Christophe Choquet & Donia Bouzid & Olivier Peyrony & Sonja Curac & Eric Revue & Jean-Paul Fontaine & Patrick Plaisance & Anthony Chauvin & Daniel Aiham Ghazali, 2020. "Analysis of Emergency Department Visits and Hospital Activity during Influenza Season, COVID-19 Epidemic, and Lockdown Periods in View of Managing a Future Disaster Risk: A Multicenter Observational S," IJERPH, MDPI, vol. 17(22), pages 1-15, November.
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    Cited by:

    1. Edoardo Guazzoni & Alberto Castelli & Alberto Polizzi & Giacomo Galanzino & Antonio Piralla & Federica Giardina & Fausto Baldanti & Eugenio Jannelli & Laura Caliogna & Gianluigi Pasta & Mario Mosconi , 2022. "Detection of SARS-CoV-2 in Cancellous Bone of Patients with COVID-19 Disease Undergoing Orthopedic Surgery: Laboratory Findings and Clinical Applications," IJERPH, MDPI, vol. 19(17), pages 1-8, August.

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