Impacts of rapid Dengue clinic services at an emergency department during the endemic outbreak

Abstract

Introduction: The global emergence of Dengue virus in the recent decades has caused the substantial health and economic burdens on patients and health-care systems, especially in the tropical and subtropical regions. In 2015, there has been a large scale of Dengue outbreak happened in a long-term low density endemic city, Tainan, in southern Taiwan. This epidemic has occurred rapidly and higher patient throughout in hospitals that led to many emergency department (ED) services operating at and near full capacity. The purpose of this study was to investigate an independent rapid Dengue clinic service (RDCS), the service that was able to relieve the overcrowding of the regular ambulatory and emergency services and set up outside the ED during the Dengue epidemic period. Methods: An observational study with patients with Dengue symptoms were enrolled in the study hospital. The health service quality assessment of the ED in a tertiary academic medical centre (study hospital) equipped with 1,000 total beds and 100 intensive care unit (ICU) beds were evaluated between the outbreak period, August and October 2015. Patients with positive Dengue test results were reviewed to evaluate the efficiency of RDCS. Results: Patients with Dengue could arrive at the hospital shortly and acquired optimal ED triage and management. Most patients were satisfied with the RDCS. Although the outbreak resulted in shortage of spare space in the ED, a proper response from the hospital administration would ameliorate the work overload of the staff and decrease the care quality of the critical patients. Conclusion: An early and restrictive intensive intervention would lead to a rapid termination of Dengue outbreak. Setting up the RDCS was beneficial to health care facilities during an endemic Dengue period. Further planning and training of RDCS would be crucial for hospital preparedness for Dengue.