Investigation of the effects of the COVID-19 pandemic on 112 emergency health services from the perspective of health management: Ordu province case study

Aim: This study aims to reveal how the 112 emergency aid system was affected during the pandemic period by examining the sociodemographic characteristics of the cases transported by ambulance in the last eight years, the reasons for ambulance requests, preliminary diagnoses and the changes in the number of cases according to years and events. Material and Method: The study is retrospective descriptive research. The data consists of the records of 748,912 cases applied to 112 command and control centers in Ordu province between 2015 and 2022. While analyzing the data, the period from the beginning of 2015 until the end of December 2019, when the Covid-19 epidemic began, was determined as the pre-pandemic period, and the period between January 2020 and the end of December 2022 was evaluated as the pandemic period. The averages of the service variables determined between these two compared periods were converted into frequency and percentage distribution tables in the Excel Program, and One-Sample T Test analysis was applied to the determined variables through the SPSS Program in order to examine the service differences between these two periods. Results: It has been determined that the highest increase in applications to emergency health services during the pandemic period was in the 65+ age group, the number of cases increased by approximately 5% each year between 2015-2020, but with the start of the pandemic, the number of cases increased by 23.2% compared to the previous year. While the highest monthly average number of cases before the pandemic was in August, it was determined that the highest increase during the pandemic was in April (38.87%) and December (39.11%). It was determined that the highest call reason was medical reasons, during the pandemic period, there was a 1357% increase in transfer reasons, 53.14% in health measures and 41.89% in other reasons, an 8.32% decrease in traffic accidents, a 6.9% increase in medical reasons, and a 22.38% increase in suicide reasons. It was determined that there was a 10.2% increase in average case transportation times in the rural region and a 18.3% increase in the urban region during the pandemic period. It was determined that during the pandemic period, duty cancellation increased by 107.4%, transfer rejection increased by 73.2%, false reporting increased by 75.6%, and other consequences decreased by 18%, waiting at the scene by 50.5%, transportation by 24.1%, transportation for medical examination by 17.4%, and transportation by another vehicle by 9.4%. . When the diagnosis groups were examined, it was determined that during the pandemic period, cardiovascular diseases decreased by 8.7% and traumas decreased by 6.7%, and there was a 30.7% increase in neurological diseases compared to the pre-pandemic period. While the annual average number of cases increased by 37.8% during the pandemic period, the annual average number of ambulances also increased by 10.2%, and while the number of cases per ambulance was 2,203 cases before the pandemic, this number increased to 2,756 cases during the pandemic period and increased by 25.10% during the pandemic period. It was determined that the ratio of Covid-19 cases requesting an ambulance during the pandemic period to total cases was 21.8% in 2020, 23.9% in 2021 and 8.3% in 2022. Conclusion: The number of calls increased during the pandemic period, and while the demand for ambulances was higher in August before the pandemic, this situation changed to December during the pandemic period. During the pandemic period, the annual average number of cases increased by 37.8% and the number of cases per ambulance increased by 25.10%. The group that requested the most ambulances was individuals over the age of 65. The reasons for application of the cases are mainly medical reasons. During the pandemic, ambulance demands in rural areas increased compared to before the pandemic, and the time to reach the case was extended in both rural and urban regions. Ambulances directed to cases requiring an ambulance have had their duties canceled after being redirected, and this situation has increased significantly compared to before the pandemic. There has also been a decrease in traffic accidents and other accidents. Since Covid-19 patients were classified and handled separately, respiratory system diseases decreased during the pandemic period. Among the years examined, Covid-19 cases (Possible-Definite) constituted 25.6% of the total cases during the three years of the pandemic process.