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Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis.
Mulholland, Rachel H; Wood, Rachael; Stagg, Helen R; Fischbacher, Colin; Villacampa, Jaime; Simpson, Colin R; Vasileiou, Eleftheria; McCowan, Colin; Stock, Sarah J; Docherty, Annemarie B; Ritchie, Lewis D; Agrawal, Utkarsh; Robertson, Chris; Murray, Josephine Lk; MacKenzie, Fiona; Sheikh, Aziz.
  • Mulholland RH; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Wood R; National Health Service Scotland, Public Health Scotland, Glasgow G2 6QE and Edinburgh EH12 9EB, UK.
  • Stagg HR; Centre for Brain Sciences, Centre for Population Health, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Fischbacher C; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Villacampa J; National Health Service Scotland, Public Health Scotland, Glasgow G2 6QE and Edinburgh EH12 9EB, UK.
  • Simpson CR; National Health Service Scotland, Public Health Scotland, Glasgow G2 6QE and Edinburgh EH12 9EB, UK.
  • Vasileiou E; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • McCowan C; School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington PO Box 600, Wellington 6140, New Zealand.
  • Stock SJ; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Docherty AB; School of Medicine, University of St Andrews, St Andrews KY16 9AJ, UK.
  • Ritchie LD; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Agrawal U; Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
  • Robertson C; Centre of Academic Primary Care, University of Aberdeen, Aberdeen AB24 3FX, UK.
  • Murray JL; School of Medicine, University of St Andrews, St Andrews KY16 9AJ, UK.
  • MacKenzie F; National Health Service Scotland, Public Health Scotland, Glasgow G2 6QE and Edinburgh EH12 9EB, UK.
  • Sheikh A; Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XQ, UK.
J R Soc Med ; 113(11): 444-453, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-814346
ABSTRACT

OBJECTIVES:

Following the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and the subsequent global spread of the 2019 novel coronavirus disease (COVID-19), health systems and the populations who use them have faced unprecedented challenges. We aimed to measure the impact of COVID-19 on the uptake of hospital-based care at a national level.

DESIGN:

The study period (weeks ending 5 January to 28 June 2020) encompassed the pandemic announcement by the World Health Organization and the initiation of the UK lockdown. We undertook an interrupted time-series analysis to evaluate the impact of these events on hospital services at a national level and across demographics, clinical specialties and National Health Service Health Boards.

SETTING:

Scotland, UK.

PARTICIPANTS:

Patients receiving hospital care from National Health Service Scotland. MAIN OUTCOME

MEASURES:

Accident and emergency (A&E) attendances, and emergency and planned hospital admissions measured using the relative change of weekly counts in 2020 to the averaged counts for equivalent weeks in 2018 and 2019.

RESULTS:

Before the pandemic announcement, the uptake of hospital care was largely consistent with historical levels. This was followed by sharp drops in all outcomes until UK lockdown, where activity began to steadily increase. This time-period saw an average reduction of -40.7% (95% confidence interval [CI] -47.7 to -33.7) in A&E attendances, -25.8% (95% CI -31.1 to -20.4) in emergency hospital admissions and -60.9% (95% CI -66.1 to -55.7) in planned hospital admissions, in comparison to the 2018-2019 averages. All subgroup trends were broadly consistent within outcomes, but with notable variations across age groups, specialties and geography.

CONCLUSIONS:

COVID-19 has had a profoundly disruptive impact on hospital-based care across National Health Service Scotland. This has likely led to an adverse effect on non-COVID-19-related illnesses, increasing the possibility of potentially avoidable morbidity and mortality. Further research is required to elucidate these impacts.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Servicio de Urgencia en Hospital / Análisis de Series de Tiempo Interrumpido / SARS-CoV-2 / COVID-19 Tipo de estudio: Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Femenino / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: J R Soc Med Año: 2020 Tipo del documento: Artículo País de afiliación: 0141076820962447

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Servicio de Urgencia en Hospital / Análisis de Series de Tiempo Interrumpido / SARS-CoV-2 / COVID-19 Tipo de estudio: Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Femenino / Humanos / Masculino País/Región como asunto: Europa Idioma: Inglés Revista: J R Soc Med Año: 2020 Tipo del documento: Artículo País de afiliación: 0141076820962447