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 outcomes 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 95% credible intervals (CrI). - "Findings During the first ten weeks of protests ED consultations declined on average by 14% for trauma (95%CrI: -40 center dot 2%, 11 center dot 5%) and 30% for respiratory causes (95%CrI: -89 center dot 4%, 30 center dot 2%), 7% for respiratory hospitalizations (95%CrI: -43 center dot 6%, 30 center dot 8%); however, none of these three results were statistically distinguishable from the null. Trauma hospitalizations, on the other hand, increased by 15% (95%CrI: 4 center dot 0%, 26 center dot 4%), and the proportion of hospitalizations per consultations increased by 40% for trauma (95%CrI: 13 center dot 1%, 68 center dot 0%) and 59% for respiratory causes (95%CrI: 29 center dot 4%, 87 center dot 9%)." - Interpretation The 2019 Chilean protests affected the use of emergency health services by increasing the trauma hospitalizations and the case hospitalization ratio per 1,000 consultations for trauma and respiratory causes. Crowdcontrol protocols must be reviewed to prevent the negative effects of civil unrest. - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)