Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 27, 2020
Date Accepted: Oct 21, 2020
Date Submitted to PubMed: Nov 4, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementing a self-assessment web-application for suspected COVID-19 patients’ triage: impact on emergency call centers
ABSTRACT
Background:
We developed a self-assessment web-application for COVID-19 symptoms which was launched in France in March 2020, when French health authorities recommended all patients with suspicion of COVID-19 to call an emergency phone number.
Objective:
Our objective was to determine if a self-assessment tool could reduce the burden on emergency call centers and help predict increasing burden on hospitals.
Methods:
Users were asked questions about underlying conditions, sociodemographic status, Zip code and main COVID-19 symptoms. Participants were advised to call an emergency call center if they reported dyspnea or complete anorexia. Data were collected on COVID-19 related calls from six emergency call centers and on Covid-19 hospitalizations from Santé Publique France and the French Ministry of Health. We examined the change in numbers of emergency calls before and after the launch of the website.
Results:
From 17 March to 2 April, 735,419 questionnaires were registered in the study area (figure 1). 121,370 (16.5%) led to a recommendation to call an emergency center. Peak of connections and recommendations to call an emergency center was observed on 22 March 2020. In the 17 days preceding the launch of the website, emergency call centers in the study area registered a total of 66,925 Covid-19 related calls and local hospitals admitted 639 patients for Covid-19, that is a ratio of 104.7 emergency calls for one hospitalization for COVID-19. In the 17 days following the launch of the website, there were 82,347 emergency calls and 6009 new hospitalizations for Covid-19, that is a ratio of 13.7 calls for one hospitalization (Chi-2 test: P<.001) (figure 2).
Conclusions:
Self-assessment web-application kick-off was followed by a ten-fold increase in COVID-19 related hospitalizations with only 23% increase in emergency calls. Peak of connections preceded peak of COVID-19 related hospitalizations by five days. While the design of the study does not allow to conclude that the self-assessment tool alone contributed to the alleviation of the emergency call centers, it does suggest that it played a role, and may be used for predicting increasing burden on hospitals. Clinical Trial: NCT04331171
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