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Impact of COVID-19 on emergency department attendance in an Australia hospital: A parallel convergent mixed methods study

journal contribution
posted on 2024-05-09, 02:35 authored by RL Jessup, C Bramston, A Beauchamp, A Gust, N Cvetanovska, Y Cao, C Haywood, P Conilione, M Tacey, B Copnell, H Mehdi, D Alnasralah, M Kirk, E Zucchi, D Campbell, A Trezona, T Haregu, B Oldenburg, K Stockman, AI Semciw
ObjectivesThe 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.DesignThis convergent parallel mixed methods study comprised two parts.SettingAn 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.ParticipantsA total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23–99).ResultsInterrupted 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.ConclusionsThis 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.

History

Journal

BMJ Open

Volume

11

Article number

e049222

Pagination

1-8

Location

London, Eng.

ISSN

2044-6055

eISSN

2044-6055

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Issue

12

Publisher

BMJ Publishing Group