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Nationwide study on trends in unplanned hospital attendance and deaths during the 7 weeks after the onset of the COVID-19 pandemic in Denmark.
Bogh, Søren Bie; Fløjstrup, Marianne; Nissen, Søren Kabell; Hanson, Stine; Bech, Mickael; Johnsen, Søren Paaske; Kristensen, Mette Rahbek; Laugesen, Line Emilie; Søndergaard, Jens; Folkestad, Lars; Christensen, Erika Frischknecht; Henriksen, Daniel Pilsgaard; Hsia, Renee Y; Graham, Colin A; Lindskou, Tim Alex; Byg, Keld-Erik; Søvsø, Morten Breinholt; Laugesen, Henrik; Hallas, Peter; Mikkelsen, Søren; Olsen, Kim Rose; Thygesen, Lau Caspar; Gamst-Jensen, Hejdi; Brabrand, Mikkel.
  • Bogh SB; Odense Patient Exploratory Network (OPEN), University of Southern Denmark, Odense, Syddanmark, Denmark.
  • Fløjstrup M; Department of Emergency Medicine, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
  • Nissen SK; Institute of Regional Health Research, Centre South West Jutland, University of Southern Denmark, Esbjerg, Denmark.
  • Hanson S; Department of Emergency Medicine, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
  • Bech M; Department of Regional Health Research, Syddansk Universitet, Odense, Syddanmark, Denmark.
  • Johnsen SP; Department of Emergency Medicine, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
  • Kristensen MR; Department of Regional Health Research, Syddansk Universitet, Odense, Syddanmark, Denmark.
  • Laugesen LE; Management & VIVE Health, VIVE - The Danish Center for Social Science Research, Copenhagen, Denmark.
  • Søndergaard J; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Folkestad L; Department of Emergency Medicine, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
  • Christensen EF; Department of Emergency Medicine, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
  • Henriksen DP; Research Unit for General Practice, Department of Public Health, Syddansk Universitet, Odense, Syddanmark, Denmark.
  • Hsia RY; Department of Endocrinology, Odense University Hospital, Odense, Denmark.
  • Graham CA; Clinic of Internal and Emergency Medicine, Department of Emergency and Trauma Care, Aalborg University Hospital, Aalborg, Denmark.
  • Lindskou TA; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Byg KE; CPER - Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
  • Søvsø MB; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
  • Laugesen H; Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.
  • Hallas P; Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, New Territories, Hong Kong.
  • Mikkelsen S; CPER - Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
  • Olsen KR; The Rheumatology Research Unit and Department of Neurology, Odense University Hospital, Odense, Denmark.
  • Thygesen LC; CPER - Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
  • Gamst-Jensen H; Prehospital Emergency Services, North Denmark Region, Aalborg, Denmark.
  • Brabrand M; Department of Emergency Medicine, Holbæk Hospital, Holbæk, Denmark.
BMJ Qual Saf ; 30(12): 986-995, 2021 12.
Article in English | MEDLINE | ID: covidwho-1218236
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

The impact of a pandemic on unplanned hospital attendance has not been extensively examined. The aim of this study is to report the nationwide consequences of the COVID-19 pandemic on unplanned hospital attendances in Denmark for 7 weeks after a 'shelter at home' order was issued.

METHODS:

We merged data from national registries (Civil Registration System and Patient Registry) to conduct a study of unplanned (excluding outpatient visits and elective surgery) hospital-based healthcare and mortality of all Danes. Using data for 7 weeks after the 'shelter at home' order, the incidence rate of unplanned hospital attendances per week in 2020 was compared with corresponding weeks in 2017-2019. The main outcome was hospital attendances per week as incidence rate ratios. Secondary outcomes were general population mortality and risk of death in-hospital, reported as weekly mortality rate ratios (MRRs).

RESULTS:

From 2 438 286 attendances in the study period, overall unplanned attendances decreased by up to 21%; attendances excluding COVID-19 were reduced by 31%; non-psychiatric by 31% and psychiatric by 30%. Out of the five most common diagnoses expected to remain stable, only schizophrenia and myocardial infarction remained stable, while chronic obstructive pulmonary disease exacerbation, hip fracture and urinary tract infection fell significantly. The nationwide general population MRR rose in six of the recorded weeks, while MRR excluding patients who were COVID-19 positive only increased in two.

CONCLUSION:

The COVID-19 pandemic and a governmental national 'shelter at home' order was associated with a marked reduction in unplanned hospital attendances with an increase in MRR for the general population in two of 7 weeks, despite exclusion of patients with COVID-19. The findings should be taken into consideration when planning for public information campaigns.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Incidence study / Prognostic study Limits: Humans Language: English Journal: BMJ Qual Saf Year: 2021 Document Type: Article Affiliation country: Bmjqs-2020-012144

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Incidence study / Prognostic study Limits: Humans Language: English Journal: BMJ Qual Saf Year: 2021 Document Type: Article Affiliation country: Bmjqs-2020-012144