Effect of weather on the number and the nature of visits to a pediatric ED

doi:10.1016/S0735-6757(98)90131-0

The American Journal of Emergency Medicine

Volume 16, Issue 4, July 1998, Pages 374-375

https://doi.org/10.1016/S0735-6757(98)90131-0 Get rights and content

Abstract

To determine whether unfavorable weather conditions affect the number and acuity of visits to a pediatric emergency department (ED), a retrospective analysis was conducted of children's hospital ED visits and weather conditions utilizing an ED log book and local climatological data during the year 1993. Visits, intensive care unit (ICU) admissions, Non-ICU admissions, time periods with favorable weather (TPF), and time periods with unfavorable weather (TPUF) were measured. Each day of the year was divided into two time periods. The time periods were labeled TPF or TPUF based on certain weather conditions. There were 632 (86%) TPF and 98 (14%) TPUF. The number of visits, non-ICU admissions, and ICU admissions during TPF were 13,008 (88%), 1,031 (87%), and 121 (86%), respectively. The number of visits, non-ICU admissions, and ICU admissions during TPUF were 1,720 (12%), 148 (13%), and 19 (14%), respectively. No significant differences in visits and admissions during TPF and TPUF were identified. Also, there was no difference identified when the distribution of visits and admissions was examined during TPUF due to different weather factors, eg, low temperature, precipitation, etc. The results show that unfavorable weather due to the types of weather factors discussed does not affect the number or the nature of visits to a pediatric ED.

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When dealing with several years of daily data, such as the number of daily admissions to a hospital’s emergency department (ED), how complex does it get to forecast into the future? With that in mind, this study has two main goals: to explore the differences between several methodologies, considering both single and multiple-seasonal patterns; and to select the most suitable model for the administration of a Portuguese hospital to use while managing their ED. To that end, we first considered the data as a time series with a single weekly seasonal pattern. We then modelled the data using time series regression, linear regression with autoregressive integrated moving average (ARIMA) errors, seasonal ARIMA and exponential smoothing techniques. Second, the data was set to be a time series with weekly and annual seasonal patterns. Then, using Fourier terms, we applied time series regression, linear regression with ARIMA errors and trigonometric exponential smoothing state space models with Box–Cox transformation, ARMA errors, Trend and Seasonal components (TBATS) for the analysis. After selecting the best-fitting models using the Akaike Information Criteria (AIC) values, we forecasted into the future and compared the results using both training and test datasets’ root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) values. The time series regression model based on seasonal variables and a weekly seasonal pattern gives the best results. However, we decided to use linear regression with ARIMA errors, seasonal variables, and both weekly and annual seasonal patterns. This produces similar results but allows for the annual seasonality to be considered, which is useful when more data is added.
Emergency department imaging: are weather and calendar factors associated with imaging volume?
2016, Clinical Radiology
Citation Excerpt :
LaGuardia airport weather station data were used as it is the closest data collection centre to the catchment area. An “extreme weather” day was defined as a day when the temperature was <0°C or >32.2°C, as has been defined elsewhere.4,5 For each day, day of the week, season, and holiday status was also recorded.
To identify weather and calendar factors that would enable prediction of daily emergency department (ED) imaging volume to aid appropriate scheduling of imaging resources for efficient ED function.
Daily ED triage and imaging volumes for radiography, computed tomography (CT), and ultrasound were obtained from hospital databases for the period between January 2011 and December 2013 at a large tertiary urban hospital with a Level II trauma centre. These data were tabulated alongside daily weather conditions (temperature, wind and precipitation), day of week, season, and holidays. Multivariate analysis was performed. Pearson correlations were used to measure the association between number of imaging studies performed and ED triage volume.
For every additional 50 triaged patients, the odds of having high (imaging volume ≥90th percentile) radiography, CT, and ultrasound volume increased by 4.3 times (p<0.001), 1.5 times (p=0.02), and 1.4 times (p=0.02), respectively. Tuesday was an independent predictor of high radiography volume (odds ratio=2.8) and Monday was an independent predictor of high CT volume (odds ratio=3.0). Weekday status was an independent factor increasing the odds of a high US volume compared to Saturday (odds ratios ranging from 5.6–9.8). Weather factors and other calendar variables were not independent predictors of high imaging volume. Using Pearson correlations, ED triage volume correlated with number of radiographs, CT, and ultrasound examinations with r=0.73, 0.37, and 0.41, respectively (p<0.0001).
As ED triage volume was found to be the only factor associated with imaging volume for all techniques, analysis of predictors of ED triage volumes at a particular healthcare facility would be useful to determine imaging needs. Although calendar and weather factors were found to be minor or non-significant independent predictors of ED imaging utilisation, these may be important in influencing the actual number of ED triages.
The association of weather on pediatric emergency department visits in Changwon, Korea (2005-2014)
2016, Science of the Total Environment
Citation Excerpt :
In some studies, warm and sunny weather appears to have significant impacts on pediatric ED visit volumes (Macgregor, 2003; Ou et al., 2005). In others however, weather was only a minor factor affecting ED attendance (Attia and Edward, 1998; Christoffel, 1985). We hypothesized that inclement weather conditions would result in decreased ED visits because non-emergent patients delay or avoid hospital visits under such conditions.
It is widely believed that patients are less likely to visit hospitals during bad weather. We hypothesized that weather and emergency department (ED) visits are associated. Thus, we investigated the association between pediatric ED visits and weather, and sought to determine whether admissions to the ED are affected by meteorological factors.
We retrospectively analyzed all 87,242 emergency visits to Samsung Changwon Hospital by pediatric patients under 19 years of age from January 2005 to December 2014. ED visits were categorized by disease. We used Poisson regression and generalized linear model to examine the relationships between current weather and ED visits. Additionally a distributed lag non-linear model was used to investigate the effect of weather on ED visits.
During this 10-year study period, the average temperature and diurnal temperature range (DTR) were 14.7 °C and 8.2 °C, respectively. There were 1,145 days of rain or snow (31.4%) during the 3,652-day study period. The volume of ED visits decreased on days of rain or snow. Additionally ED visits increased 2 days after rainy or snowy days. The volume of ED visits increased 1.013 times with every 1 °C increase in DTR. The volume of ED visits by patients with trauma, digestive diseases, and respiratory diseases increased when DTR was over 10 °C. As rainfall increased to over 25 mm, the ward admission rate (23.8%, p = 0.018) of ED patients increased significantly.
The volume of ED visits decreased on days of rain or snow and the ED visits were increased 2 days after rainy or snowy days. The volume of ED visits increased for every 1 °C increase in DTR.
Using an emergency department syndromic surveillance system to investigate the impact of extreme cold weather events
2014, Public Health
Citation Excerpt :
Diagnosis codes were received for 77% of attendances reported here, however it is not known whether the remaining attendances without a code would have been relevant to this investigation. Previous investigations into the impact of ‘bad’ or ‘unfavourable’ weather on ED attendances have shown differing results, with most reporting minimal or no impact.21–23 However, severe or extreme weather events such as heavy snowfall or ice have been shown to impact on the workload and types of diagnoses made in emergency departments, for trauma cases in particular.19,24
This report describes the development of novel syndromic cold weather public health surveillance indicators for use in monitoring the impact of extreme cold weather on attendances at EDs, using data from the 2010–11 and 2011–12 winters.
A number of new surveillance indicators were created specifically for the identification and monitoring of cold weather related ED attendances, using the diagnosis codes provided for each attendance in the Emergency Department Syndromic Surveillance System (EDSSS), the first national syndromic surveillance system of its kind in the UK. Using daily weather data for the local area, a time series analysis to test the sensitivity of each indicator to cold weather was undertaken.
Diagnosis codes relating to a health outcome with a potential direct link to cold weather were identified and assigned to a number of ‘cold weather surveillance indicators’. The time series analyses indicated strong correlations between low temperatures and cold indicators in nearly every case. The strongest fit with temperature was cold related fractures in females, and that of snowfall was cold related fractures in both sexes.
Though currently limited to a small number of sentinel EDs, the EDSSS has the ability to give near real-time detail on the magnitude of the impact of weather events. EDSSS cold weather surveillance fits well with the aims of the Cold Weather Plan for England, providing information on those particularly vulnerable to cold related health outcomes severe enough to require emergency care. This timely information aids those responding to and managing the effects on human health, both within the EDs themselves and in the community as a whole.
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To explore the relationship between the number of patients presenting to the Emergency Department and the weather. To determine if the number of non-urgent cases presenting to the ED is affected by the weather.
Retrospective review of all presentations to the ED of a tertiary referral hospital in the south-west of Sydney, Australia over a 1 year period. Total daily numbers of patient presentations and their triage acuity were correlated with temperature, rainfall, day of the week and the absence or presence of a Public holiday.
During the study period 46,903 patients presented to the ED with an average of 128.5 patients a day. Rainfall occurred on 135 days. There was a positive correlation between day of the week (P < 0.001) and the presence of a public holiday (P < 0.001) on ED attendances. Increasing maximum daily temperature was also associated with a rise in ED presentations (P = 0.04). Daily rainfall did not significantly influence ED attendance numbers (P = 0.07). The presence of a Public holiday was the only significant variable affecting the numbers of non-urgent presentations (P = 0.003).
Meteorological factors such as rainfall and temperature impact minimally on ED attendances. Day of the week and Public holidays are more important variables impacting on total ED workload and resource planning should be guided by this.
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^☆: Presented at the Ambulatory Pediatric Association/Society for Pediatric Research annual meeting, May 10, 1996, Washington, DC.

¹: Dr Edward is currently affiliated with Memorial Medical Center, Las Cruces, NM.

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Brief reportEffect of weather on the number and the nature of visits to a pediatric ED☆

Abstract

Am J Emerg Med

Am J Emerg Med

Brief report
Effect of weather on the number and the nature of visits to a pediatric ED☆