A Kociejowski1, C Hobart1, R Jina2, I Aberman3, E Backhurst3, A Beaumont3, J Crompton1, R Sneep2, F Cantle2, H Dodhia1. 1. Health Intelligence Team, Public Health Directorate, Adults and Health, Lambeth Council, London SW2 1EG, UK. 2. Emergency Department, King's College Hospital NHS Foundation Trust London, London SE5 9RS, UK. 3. GKT School of Medical Education, King's College London, London WC2R 2LS, UK.
Abstract
BACKGROUND: Concerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown. METHODS: This case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March-May 2020) compared with equivalent weeks in 2019. RESULTS: We found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the 'Infections' diagnostic category. CONCLUSIONS: COVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.
BACKGROUND: Concerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown. METHODS: This case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March-May 2020) compared with equivalent weeks in 2019. RESULTS: We found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the 'Infections' diagnostic category. CONCLUSIONS: COVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.
Authors: Marion M Mafham; Enti Spata; Raphael Goldacre; Dominic Gair; Paula Curnow; Mark Bray; Sam Hollings; Chris Roebuck; Chris P Gale; Mamas A Mamas; John E Deanfield; Mark A de Belder; Thomas F Luescher; Tom Denwood; Martin J Landray; Jonathan R Emberson; Rory Collins; Eva J A Morris; Barbara Casadei; Colin Baigent Journal: Lancet Date: 2020-07-14 Impact factor: 79.321
Authors: Rachel H Mulholland; Rachael Wood; Helen R Stagg; Colin Fischbacher; Jaime Villacampa; Colin R Simpson; Eleftheria Vasileiou; Colin McCowan; Sarah J Stock; Annemarie B Docherty; Lewis D Ritchie; Utkarsh Agrawal; Chris Robertson; Josephine Lk Murray; Fiona MacKenzie; Aziz Sheikh Journal: J R Soc Med Date: 2020-10-04 Impact factor: 5.344