Effects of 2019's Social Protests on Emergency Health Services Utilization and Case Severity in Santiago, Chile

Abstract

Background: On October 18th, 2019, protestors gathered across Chile to call for social equity, resulting in widespread civil unrest and violent confrontation with the police. In this study we quantify the effects of the 2019 Chilean protests on emergency health services utilization and inpatient admission in Santiago. Methods: We used weekly emergency department (ED) admissions (2015-2019) from three large public hospitals near the focal point of protests in Santiago. The exposure period was from October 18th to December 31st, 2019. The outcome were the number of weekly consultations and hospitalizations by trauma and respiratory causes and the proportion of hospitalizations among consultants per 1,000. We implemented Bayesian structural time series models to calculate the absolute and relative effects and their 95% credible intervals (CrI). Findings: ED consultations declined by 15% for trauma (95%CrI: -42·6%, 12.1%) and 46% for respiratory causes (95%CrI: -95·3%, 3·9%) during the first ten weeks of social protests. In contrast, trauma hospitalizations increased by 17% (95%CrI: 4.9%, 29.1%), and the proportion of hospitalizations among consultations increased by 41% for trauma (95%CrI: 11·1%, 69·1%) and 71% for respiratory causes (95%CrI: 36·5%, 106·7%). Interpretation: The 2019 Chilean protests affected the use of emergency health services by lowering the number of consultations due to trauma and respiratory causes, while increasing the rate of hospitalizations among consulting patients. Crowd-control protocols must be reviewed to prevent negative effects of civil unrest on population health. Funding Information: Comision Nacional de Investigacion Cientifica y Tecnologica and the Vice Chancellor of Research at Universidad Mayor, Chile. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The dataset was publicly available on the internet (http://www.deis.cl); thus, no IRB approval was necessary to conduct and publish this work.