{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T19:11:50Z","timestamp":1773515510711,"version":"3.50.1"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1935789322002762_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>Study the effect of the coronavirus disease (COVID-19) pandemic on emergency room (ER) utilization for musculoskeletal (MSK) complaints.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322002762_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Data from ER encounters in a teaching hospital for years 2019 and 2020 were extracted from an electronic database. The ICD-10-CM codes were used to assign the primary diagnosis. Joinpoint regression was applied to a time-series to detect changes in daily encounters (all-cause and MSK). Total number and median daily encounters were calculated by year, sex, age groups, and diagnostic codes for each year.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322002762_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Overlapping intervals within March 2020 showed drops of 8.1 all-cause encounters per day (95% CI: 4.8-11.5), and 1.2 MSK encounters per day (95% CI: 0.8-1.7), resulting in net losses for the year of 33.2% for all-cause and 35.8% for MSK encounters. Reductions were observed for both sexes and all age groups. MSK codes with largest declines were low back pain, joint pain, and limb pain.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322002762_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The COVID-19 pandemic resulted in major reductions in all-cause and MSK encounters in the ER of an academic hospital probably due to governmental restrictions and a change in patients behaviors. Persistence of the observed reduction suggests that patients requiring ER services delayed seeking care for MSK and other health conditions.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/dmp.2022.276","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T07:17:00Z","timestamp":1670311020000},"source":"Crossref","is-referenced-by-count":4,"title":["Effect of the COVID-19 Pandemic on Musculoskeletal Care in the Emergency Room"],"prefix":"10.1017","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8471-2248","authenticated-orcid":false,"given":"Walter R.","family":"Frontera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos R.","family":"Latimer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"de Jes\u00fas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Pab\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 G.","family":"Conde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"S1935789322002762_ref17","first-page":"352","volume-title":"Fundamentals of biostatistics","author":"Rosner","year":"2016"},{"key":"S1935789322002762_ref2","first-page":"699","article-title":"Impact of the COVID-19 pandemic on emergency department visits\u2014United States, January 1, 2019\u2013May 30, 2020","volume":"69","author":"Hartnett","year":"2020","journal-title":"MMWR"},{"key":"S1935789322002762_ref18","first-page":"413","volume-title":"Fundamentals of biostatistics","author":"Rosner","year":"2016"},{"key":"S1935789322002762_ref25","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v014.i09"},{"key":"S1935789322002762_ref5","first-page":"68","article-title":"Musculoskeletal conditions in the emergency room: a teaching opportunity for medical students and residents","volume":"40","author":"Font\u00e1nez","year":"2021","journal-title":"P R Health Sci J."},{"key":"S1935789322002762_ref8","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-80309-x"},{"key":"S1935789322002762_ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-020-00810-0"},{"key":"S1935789322002762_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/anzs.12200"},{"key":"S1935789322002762_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.06.044"},{"key":"S1935789322002762_ref14","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e10"},{"key":"S1935789322002762_ref12","first-page":"20","article-title":"Segmented: an R Package to Fit Regression Models with Broken-Line Relationships","volume":"8","author":"Muggeo","year":"2008","journal-title":"R News."},{"key":"S1935789322002762_ref20","volume-title":"RStudio: integrated development environment for R","year":"2020"},{"key":"S1935789322002762_ref11","unstructured":"11. ICD-10-CM Official Guidelines for Coding and Reporting. National Center for Health Statistics, Centers for Disease Control and Prevention. Published 2021. Accessed December 12, 2021. https:\/\/www.cdc.gov\/nchs\/data\/icd\/10cmguidelines-FY2021"},{"key":"S1935789322002762_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2019.75"},{"key":"S1935789322002762_ref9","unstructured":"9. Poblaci\u00f3n Total en Municipios de Puerto Rico 2010\u20132019. Puerto Rico Statistics Institute. Accessed June 11, 2021.https:\/\/censo.estadisticas.pr\/estimadospoblacionales"},{"key":"S1935789322002762_ref21","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v014.i06"},{"key":"S1935789322002762_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"S1935789322002762_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1545"},{"key":"S1935789322002762_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2020.303"},{"key":"S1935789322002762_ref16","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2020.332"},{"key":"S1935789322002762_ref19","volume-title":"R: a language and environment for statistical computing","year":"2021"},{"key":"S1935789322002762_ref1","unstructured":"1. World Health Organization, https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020"},{"key":"S1935789322002762_ref26","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.ajem.2020.09.009","article-title":"COVID-19 and emergency department volume: the patients return but have different characteristics","volume":"45","author":"Heppner","year":"2021","journal-title":"Am J Emerg Med."},{"key":"S1935789322002762_ref6","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.110.BJO-2020-0120.R1"},{"key":"S1935789322002762_ref7","first-page":"e13143","article-title":"Musculoskeletal attendances to a minor injury department during a pandemic","volume":"13","author":"Dowell","year":"2021","journal-title":"Cureus."},{"key":"S1935789322002762_ref23","first-page":"3059","article-title":"Testing with a nuisance parameter present only under the alternative: a score-based approach with application to segmented modelling","volume":"86","author":"Muggeo","year":"2016","journal-title":"JSCS."},{"key":"S1935789322002762_ref10","volume-title":"Revision","year":"2015"},{"key":"S1935789322002762_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2020.281"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789322002762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T06:43:30Z","timestamp":1676357010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789322002762\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,6]]},"references-count":28,"alternative-id":["S1935789322002762"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2022.276","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"value":"1935-7893","type":"print"},{"value":"1938-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,6]]},"article-number":"e310"}}