Effect of the SARS outbreak on visits to a community hospital emergency department.
OBJECTIVE
To examine the effect of severe acute respiratory syndrome (SARS) on visits to a community hospital emergency department (ED) during the early stage of the Toronto outbreak in 2003 and for the same period in 2004. We focused on visits for respiratory illness (SARS-like symptoms) and different age groups.


METHODS
This study is a retrospective review of ED discharge diagnoses obtained from a computerized database, examining the 4-week period starting March 28 for the years 2001-2004. We obtained the discharge diagnosis, age and visit date for each ED patient during the relevant time intervals, then compared visit data from 2003 and 2004 with a baseline derived from the average number of visits during 2001 and 2002. We constructed groupings based on age and respiratory-illness symptoms.


RESULTS
During the SARS outbreak in 2003, ED visits declined by 21% (95% confidence interval [CI], 18%-24%) over the 4-week study period. The greatest reduction was for combined infant and toddler visits (69%; 95% CI, 58%-79%); these did not recover the following year. However, during the SARS outbreak there was a large increase in the number of visits for respiratory illnesses in adults (61%; 95% CI, 46%-75%) and in teenagers (132%; 95% CI, 82%-182%).


CONCLUSIONS
During the SARS outbreak, total ED visits fell. The relative decline was most notable for infants and toddlers. By contrast, there was an increase in respiratory illness-related visits for adults and teenagers. In 2004, the year following the SARS outbreak, visit patterns shifted toward baseline levels, but ED visits by infants and toddlers remained depressed.
Heiber
Michael
M
Department of Family and Community Medicine, Scarborough Hospital, Toronto, Ontario, Canada.
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W Y Wendy
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D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D018709:Statistics, Nonparametric