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Fear of pandemic influenza clogs EDs even when disease is not present

tetano

Editor, Senior Moderator
Fear of pandemic influenza clogs EDs even when disease is not present
Published: Tuesday, May 4, 2010 - 00:17 in Health & Medicine

A study of emergency department (ED) activity before and during the H1N1 influenza pandemic highlights the role public fear can play in unnecessarily straining medical facilities and will aid in ongoing preparations for public health emergencies, according to the authors. When EDs experience surges in patient volumes and become overcrowded during a pandemic, the quality and timeliness of medical care suffers, noted William M. McDonnell, MD, JD, who will present study findings Tuesday, May 4 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

To determine how public fear over H1N1 influenza and presence of the disease in the community affected use of a pediatric ED, Dr. McDonnell and his colleagues compared usage rates during three one-week periods. Fear week was a period of heightened public concern before the disease was present in the community. Flu week was a period of active pandemic disease. Control week was a period prior to the onset of concern.

Results showed that parents brought their children to the ED in increased numbers during fear week. Compared to the control week, the number of patients was up by 16.3 percent, and children ages 1-4 years comprised 54 percent of the increase.

When H1N1 later arrived in the community (flu week), the ED saw a second surge in patient volumes. The number of patients increased 22.4 percent compared to the control week, and children ages 5-18 years accounted for 91.7 percent of the increase.

"Our study shows that public fear of disease, even when actual disease is not present, can bring about the problems of emergency department overcrowding," said Dr. McDonnell, assistant professor of pediatrics in the Division of Pediatric Emergency Medicine and adjunct professor of law at S.J. Quinney College of Law, University of Utah. "As we continue developing our public health emergency planning programs, we must ensure that responsible news media coverage of public health issues provides the benefits of a free and vigorous press, without unnecessarily harming the public health."


Source: American Academy of Pediatrics

http://esciencenews.com/articles/20...uenza.clogs.eds.even.when.disease.not.present
 
Re: Fear of pandemic influenza clogs EDs even when disease is not present

[1493.385] Should We Fear Flu Fear Itself? Lessons from the Spring 2009 H1N1 Influenza Outbreak

William M. McDonnell, Douglas S. Nelson, Jeff E. Schunk. Department of Pediatrics, University of Utah, Salt Lake City, UT.

BACKGROUND: Medical care provided in emergency departments (EDs) is crucial to the American health care system. Episodic surges in patient volumes may compromise EDs' ability to deliver adequate care, as shown by recent experience with H1N1 influenza (Flu). Media reports play an important role in informing the public about potential health threats, but the effects of media-induced anxiety on ED patient volumes is unclear.
OBJECTIVE: We sought to examine the effect of widespread public concern about Flu, in the absence of substantial disease prevalence, on ED utilization.
DESIGN/METHODS: We reviewed age-stratified ED utilization data from a centralized database of Intermountain Health Care, an integrated health care system operating 18 Utah hospital EDs. We compared the number of ED visits during three one-week periods: a) a period of heightened public concern regarding H1N1 influenza before the disease was present in the community (Fear Week); b) a period of active pandemic disease (Flu Week); and c) a week prior to the onset of concern (Control Week). Fear Week was identified from an analysis of statewide Google? electronic searches for "swine flu," and from media and government announcements about H1N1 influenza. Flu Week was identified from statewide epidemiological Flu data.
RESULTS: Data were reviewed from 22,608 visits during the three study periods. Fear Week (n=7712) and Flu Week (n=7687) were compared to Control Week (n=7209). Fear Week showed a 7.0% increase in census (Δn=503, 95% CI: 6, 8). Pediatric visits increased 19.7% (456/2311) while adult visits increased 1% (47/4898). The difference between these proportions is significant (18.7%, 95% CI: 17, 20). Flu Week also showed a volume increase over Control Week, increasing 6.6% (Δn=478, 95% CI: 6, 7). Pediatric patient visits increased 10.6% (245/2311) while adult volumes increased by 4.8% (234/4898). The difference between these proportions is significant (4.8%, 95% CI:4,7).
CONCLUSIONS: At a time of heightened public concern regarding Flu, but little disease prevalence, study EDs experienced a significant increase in patient volumes due to an influx of pediatric patients. Parental anxiety regarding Flu increased ED visits by pediatric patients to a greater extent than the epidemic of actual disease that followed.
E-PAS20101493.385

Date: Saturday, May 1, 2010
Poster Session: Emergency Medicine (1:00 PM - 4:00 PM)
Presentation Time: 1:00 PM
Room: Exhibit Hall C - Vancouver Convention Centre
Board Number: 385
Course Number: 1493

http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_720&terms
 
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