气候变化领域集成服务门户(CCPortal): Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington

CCPortal

DOI	10.1002/emp2.13098
	Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington
	Wettstein, Zachary S.; Hall, Jane; Buck, Cameron; Mitchell, Steven H.; Hess, Jeremy J.
发表日期	2024
EISSN	2688-1152
起始页码	5
结束页码	1
卷号	5 期号:1
英文摘要	ObjectivesExtreme heat events (EHEs) are associated with excess healthcare utilization but specific impacts on emergency department (ED) operations and throughput are unknown. In 2021, the Pacific Northwest experienced an unprecedented heat dome that resulted in substantial regional morbidity and mortality. The aim of this study was to examine its impact on ED utilization, unplanned hospitalization, and hospital operations in a large academic healthcare system.MethodsRetrospective electronic medical records from three Seattle-area hospitals were used to compare healthcare utilization during the EHE compared to a pre-event reference period within the same month. Interrupted time series analysis was used to evaluate the association between EHE exposure and ED visits and hospitalizations. Metrics of ED crowding for the EHE were compared to the reference period using Student's t-tests and chi-squared tests. Additionally, multivariable Poisson regression was used to identify risk factors for heat-related illness and hospital admission.ResultsInterrupted time series analysis showed an increase of 21.7 ED visits per day (95% confidence interval [CI] = 14.7, 28.6) and 9.9 unplanned hospitalizations per day (95% CI = 8.3, 11.5) during the EHE, as compared to the reference period. ED crowding and process measures also displayed significant increases, becoming the most pronounced by day 3 of the EHE; the EHE was associated with delays in ED length of stay of 1.0 h (95% CI = 0.4, 1.6) compared to the reference period. Higher incidence rate ratios for heat-related illness were observed for patients who were older (incidence rate ratio [IRR] = 1.02; 95% CI = 1.01,1.03), female (IRR = 1.47; 95% CI = 1.06, 2.04), or who had pre-existing diabetes (IRR = 3.19; 95% CI = 1.47, 6.94).ConclusionsThe 2021 heat dome was associated with a significant increase in healthcare utilization including ED visits and unplanned hospitalizations. Substantial impacts on ED and hospital throughput were also noted. These findings contribute to the understanding of the role extreme heat events play on impacting patient outcomes and healthcare system function.
英文关键词	climate change; disaster; heat; heat wave; operations
语种	英语
WOS研究方向	Emergency Medicine
WOS类目	Emergency Medicine
WOS记录号	WOS:001145512000001
来源期刊	JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS OPEN
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/290974
作者单位	University of Washington; University of Washington Seattle; University of Washington; University of Washington Seattle
推荐引用方式 GB/T 7714	Wettstein, Zachary S.,Hall, Jane,Buck, Cameron,et al. Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington[J],2024,5(1).
APA	Wettstein, Zachary S.,Hall, Jane,Buck, Cameron,Mitchell, Steven H.,&Hess, Jeremy J..(2024).Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington.JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS OPEN,5(1).
MLA	Wettstein, Zachary S.,et al."Impacts of the 2021 heat dome on emergency department visits, hospitalizations, and health system operations in three hospitals in Seattle, Washington".JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS OPEN 5.1(2024).