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

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 parall...

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Autores principales: Jessup, Rebecca Leigh, Bramston, C, Beauchamp, A, Gust, A, Cvetanovska, N, Cao, Y, Haywood, C, Conilione, P, Tacey, Mark, Copnell, Beverley, Mehdi, H, Alnasralah, Dialla, Kirk, M, Zucchi, Emilliano, Campbell, D, Trezona, A, Haregu, T, Oldenburg, Brian, Stockman, K, Semciw, Adam Ivan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718342/
https://www.ncbi.nlm.nih.gov/pubmed/36927862
http://dx.doi.org/10.1136/bmjopen-2021-049222
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author Jessup, Rebecca Leigh
Bramston, C
Beauchamp, A
Gust, A
Cvetanovska, N
Cao, Y
Haywood, C
Conilione, P
Tacey, Mark
Copnell, Beverley
Mehdi, H
Alnasralah, Dialla
Kirk, M
Zucchi, Emilliano
Campbell, D
Trezona, A
Haregu, T
Oldenburg, Brian
Stockman, K
Semciw, Adam Ivan
author_facet Jessup, Rebecca Leigh
Bramston, C
Beauchamp, A
Gust, A
Cvetanovska, N
Cao, Y
Haywood, C
Conilione, P
Tacey, Mark
Copnell, Beverley
Mehdi, H
Alnasralah, Dialla
Kirk, M
Zucchi, Emilliano
Campbell, D
Trezona, A
Haregu, T
Oldenburg, Brian
Stockman, K
Semciw, Adam Ivan
author_sort Jessup, Rebecca Leigh
collection PubMed
description 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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spelling pubmed-87183422022-01-04 Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study Jessup, Rebecca Leigh Bramston, C Beauchamp, A Gust, A Cvetanovska, N Cao, Y Haywood, C Conilione, P Tacey, Mark Copnell, Beverley Mehdi, H Alnasralah, Dialla Kirk, M Zucchi, Emilliano Campbell, D Trezona, A Haregu, T Oldenburg, Brian Stockman, K Semciw, Adam Ivan BMJ Open Health Services Research 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. BMJ Publishing Group 2021-12-30 /pmc/articles/PMC8718342/ /pubmed/36927862 http://dx.doi.org/10.1136/bmjopen-2021-049222 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Health Services Research
Jessup, Rebecca Leigh
Bramston, C
Beauchamp, A
Gust, A
Cvetanovska, N
Cao, Y
Haywood, C
Conilione, P
Tacey, Mark
Copnell, Beverley
Mehdi, H
Alnasralah, Dialla
Kirk, M
Zucchi, Emilliano
Campbell, D
Trezona, A
Haregu, T
Oldenburg, Brian
Stockman, K
Semciw, Adam Ivan
Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title_full Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title_fullStr Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title_full_unstemmed Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title_short Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
title_sort impact of covid-19 on emergency department attendance in an australia hospital: a parallel convergent mixed methods study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718342/
https://www.ncbi.nlm.nih.gov/pubmed/36927862
http://dx.doi.org/10.1136/bmjopen-2021-049222
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