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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.
  • Jessup RL; Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Victoria, Australia rebecca.jessup@nh.org.au.
  • Bramston C; Allied Health, Northern Health, Epping, Victoria, Australia.
  • Beauchamp A; School of Rural Health, Monash University, Warrigal, Victoria, Australia.
  • Gust A; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.
  • Cvetanovska N; School of Allied Health, Human Services and Sport, LaTrobe University, Bundoora, Victoria, Australia.
  • Cao Y; Allied Health, Northern Health, Epping, Victoria, Australia.
  • Haywood C; School of Rural Health, Monash University, Warrigal, Victoria, Australia.
  • Conilione P; Department of Medicine - Western Health, The University of Melbourne, St Albans, Victoria, Australia.
  • Tacey M; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.
  • Copnell B; School of Rural Health, Monash University, Warrigal, Victoria, Australia.
  • Mehdi H; School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
  • Alnasralah D; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.
  • Kirk M; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
  • Zucchi E; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.
  • Campbell D; Office of Research, Northern Health, Epping, Victoria, Australia.
  • Trezona A; School of Nursing and Midwifery, LaTrobe University, Melbourne, Victoria, Australia.
  • Haregu T; Office of Research, Northern Health, Epping, Victoria, Australia.
  • Oldenburg B; Office of Research, Northern Health, Epping, Victoria, Australia.
  • Stockman K; Department of Medicine, Rockhampton Hospital, Rockhampton, Queensland, Australia.
  • Semciw AI; Transcultural and Language Services, Northern Health, Melbourne, Victoria, Australia.
BMJ Open ; 11(12): e049222, 2021 12 30.
Article in English | MEDLINE | ID: covidwho-1594463
ABSTRACT

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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study Limits: Adult / Aged / Humans / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-049222

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study Limits: Adult / Aged / Humans / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-049222