PT  - JOURNAL ARTICLE
AU  - Jessup, Rebecca Leigh
AU  - Bramston, C
AU  - Beauchamp, A
AU  - Gust, A
AU  - Cvetanovska, N
AU  - Cao, Y
AU  - Haywood, C
AU  - Conilione, P
AU  - Tacey, Mark
AU  - Copnell, Beverley
AU  - Mehdi, H
AU  - Alnasralah, Dialla
AU  - Kirk, M
AU  - Zucchi, Emilliano
AU  - Campbell, D
AU  - Trezona, A
AU  - Haregu, T
AU  - Oldenburg, Brian
AU  - Stockman, K
AU  - Semciw, Adam Ivan
TI  - Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
AID  - 10.1136/bmjopen-2021-049222
DP  - 2021 Dec 01
TA  - BMJ Open
PG  - e049222
VI  - 11
IP  - 12
4099  - http://bmjopen.bmj.com/content/11/12/e049222.short
4100  - http://bmjopen.bmj.com/content/11/12/e049222.full
SO  - BMJ Open2021 Dec 01; 11
AB  - 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.Data are available upon reasonable request. De-identified participant data from this research will be shared upon reasonable request with the corresponding author.