What the study found
Emergency departments at two German university hospitals saw fewer patients during the COVID-19 pandemic than in 2019, along with changes in length of stay, referrals to intensive care unit (ICU) care, and in-hospital mortality. Staff also described increased workload and two main tensions in care: balancing optimal treatment with limited resources, and delivering care while following hygiene rules.
Why the authors say this matters
The authors say the study can help identify lessons learned for future health crises and improve preparedness in emergency departments. They conclude that an interdisciplinary approach, including organizational changes, communication pathways, and emotional support for staff, is crucial for improving response capacity, resilience, and adaptability during future pandemics.
What the researchers tested
The researchers used an exploratory, convergent mixed-method design. They conducted 16 semi-structured interviews with emergency department staff and thematically analyzed those interviews, while also descriptively analyzing routine data from 56,842 emergency department patient records and using group comparisons and mixed-effects models to compare pandemic-era patterns with 2019.
What worked and what didn't
The data showed a decline in patient numbers during the COVID-19 pandemic. Compared with 2019, there were also changes in length of stay, ICU referrals, and in-hospital mortality, and staff reported that rapid adjustments and a flood of information increased workload. The study also identified six preparedness areas: avoiding information overload and improving communication, staff safety and emotional support, early infection detection, hygienic distancing, resource management in patient care, and efficient discharge management.
What to keep in mind
The study was conducted at two university emergency departments in Germany, so the findings are limited to that setting. The abstract does not describe additional limitations beyond the study scope and the available data.
Key points
- Emergency department patient numbers declined during the COVID-19 pandemic compared with 2019.
- Changes were also seen in length of stay, ICU referrals, and in-hospital mortality.
- Staff reported increased workload because of rapid adjustments and a flood of information.
- The study identified two main care tensions: conserving resources and following hygiene guidelines.
- Six preparedness areas were highlighted, including communication, staff safety, infection detection, and discharge management.
Disclosure
- Research title:
- COVID-19 changed emergency department care patterns in Germany
- Authors:
- Jennifer Hitzek, Bettina Völzer, Martina Schmiedhofer, Dörte Huscher, Anja Alberter, Miriam Mayer, Martin Möckel, Anna Slagman
- Institutions:
- Humboldt-Universität zu Berlin, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin
- Publication date:
- 2026-03-10
- OpenAlex record:
- View
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