Impact of the beginning of COVID 19 pandemic on prehospital emergency medical service utilization

Patients seek emergency medical service (EMS) help for non-urgent conditions every day. The aim of this study was to analyze the impact of the first 28 days of the COVID-19 pandemic in Croatia on prehospital EMS utilization. A retrospective observational cohort study of all patients attended by EMS teams of Sveti Ivan Zelina, Croatia, in the period from March 11 through April 8, and for every year between 2015 and 2020. The data from the mentioned period for 2020 was also compared with the 8 weeks earlier period (December 18, 2019, through January 15, 2020). Data was collected from eHitna software, and the main measure of outcome was determined by the International Classification of Disease (ICD-10) diagnostic code, assigned by the attending physician. During the study period, we observed 1171 walk-in patients and 750 on field interventions. There was a decrease of 41% in walk-in cases during the pandemic from an average of 209 (± 36.89) cases between 2015 and 2019 to 123 walk-in cases in 2020. Also, there was a significant increase in the proportion of cases involving injuries by 11% (p = 0.01) and mental health issues by 5% (p ˂ 0.01). Considering that there were 41% more walk-in visits in the pre-pandemic period, we conclude that EMS is used in large numbers for non-emergency conditions