Jordan Journal of Nursing Research
Impact of COVID-19 Lockdown on Emergency Department Visits, Hospital Admissions, and Mortality in Northern Jordan: An Interrupted Time Series Analysis

Authors:

Alaa Dalky; Muhannad Ababneh; Mahmoud Smadi; Mohanad El-Bashir; Liqaa Raffee; Abdullah Al-Kasasbeh;

Abstract:

Background: The Jordanian healthcare system was significantly affected by the COVID-19 pandemic as lockdowns and infections strained the healthcare system. The impact of the ensuing national lockdown on emergency department visits, admissions, and mortality is unclear. Objective: To assess the impact of the COVID-19 lockdown on the pattern of emergency department visits, admissions, and mortality at a major hospital in Northern Jordan.  Methods: An electronic database belonging to King Abdullah University Hospital was used for a retrospective analysis, the data was accessed in 2022. All patients who visited the emergency department before, during, and after the lockdown in 2020 and 2019 were analyzed using an interrupted time-series analysis. Descriptive statistics were calculated for categorical variables, followed by the Wilcoxon Signed-Ranks Test to detect mean differences. Results: ED visits decreased by 53.5% during the lockdown period and by 22% after the lockdown compared to the same period a year prior. During lockdown, hospital admissions rose significantly from 11.8% in 2019 to 17.1% in 2020, with 23.96% critical care unit admissions. Post-lockdown, ED admissions increased from 11.3% in 2019 to 16.3% in 2020, with critical care admissions rising to 30.10%, and the mortality rate increased by 50%. Conclusion: It noted a decrease in hospital admissions and emergency visits during lockdown, but an increase in mortality rates. Future planning should focus on optimizing care for life-threatening emergencies, improving national emergency preparedness, and developing Hospital Readiness Checklists for effective response to emergencies like COVID-19. Implication for nursing: Nursing has faced challenges and changes due to the COVID-19 lockdown. Patient admissions decreased after the 2020 lockdown, impacting nursing practice, mental health, and patient care. Nurses should be adapted to telehealth services, maintain care remotely, and address nurses’ mental health issues. Virtual tools should be utilized to connect with patients.

Keywords:

Jordan, COVID-19 lockdown, Emergency department, Hospital admission, Interrupted Time Series