RT Journal Article
SR Electronic
T1 Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e049222
DO 10.1136/bmjopen-2021-049222
VO 11
IS 12
A1 Jessup, Rebecca Leigh
A1 Bramston, C
A1 Beauchamp, A
A1 Gust, A
A1 Cvetanovska, N
A1 Cao, Y
A1 Haywood, C
A1 Conilione, P
A1 Tacey, Mark
A1 Copnell, Beverley
A1 Mehdi, H
A1 Alnasralah, Dialla
A1 Kirk, M
A1 Zucchi, Emilliano
A1 Campbell, D
A1 Trezona, A
A1 Haregu, T
A1 Oldenburg, Brian
A1 Stockman, K
A1 Semciw, Adam Ivan
YR 2021
UL http://bmjopen.bmj.com/content/11/12/e049222.abstract
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.