Jessup RL, Bramston C, Beauchamp A, Gust A, Cvetanovska N, Cao Y, Haywood C, Conilione P, Tacey M, Copnell B, Mehdi H, Alnasralah D, Kirk M, Zucchi E, Campbell D, Trezona A, Haregu T, Oldenburg B, Stockman K, Semciw AI. Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study.
BMJ Open 2021;
11:e049222. [PMID:
36927862 PMCID:
PMC8718342 DOI:
10.1136/bmjopen-2021-049222]
[Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES
The COVID-19 pandemic has changed the way people are accessing healthcare. The aim of this study was to examine the impact of COVID-19 on emergency department (ED) attendance for frequent attenders and to explore potential reasons for changes in attendance.
DESIGN
This convergent parallel mixed methods study comprised two parts.
SETTING
An interrupted time-series analysis evaluated changes in ED presentation rates; interviews investigated reasons for changes for frequent ED users in a culturally and linguistically diverse setting.
PARTICIPANTS
A total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23-99).
RESULTS
Interrupted time-series analysis from 4868 eligible participants showed an instantaneous decrease in weekly ED presentations by 36% (p<0.001), with reduction between 45% and 67% across emergency triage categories. 32% did not know they could leave home to seek care with differences seen in English versus non-English speakers (p<0.001). 35% reported postponing medical care. There was a high fear about the health system becoming overloaded (mean 4.2 (±2) on 6-point scale). Four key themes emerged influencing health-seeking behaviour: fear and/or avoidance of hospital care; use of telehealth for remote assessment; no fear or avoidance of hospital care; not leaving the house for any reason.
CONCLUSIONS
This study demonstrated reduced ED use by a vulnerable population of previously frequent attenders. COVID-19 has resulted in some fear and avoidance of hospitals, but has also offered new opportunity for alternative care through telehealth.
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