The impact of COVID-19 on an Irish Emergency Department (ED): a cross-sectional study exploring the factors influencing ED utilisation prior to and during the pandemic from the patient perspective

BMC Emergency Medicine

卷:22

Research

Gillian Corey¹  Carrie Garavan²  Louise A. Barry³  Rose Galvin³  Collette Devlin³  Gerard McCarthy⁴  Fergal Cummins⁵  Damien Ryan⁵  Niamh M. Cummins⁶ 

[1] Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland;ALERT Limerick EM Education Research Training, Emergency Department, University Hospital Limerick, Limerick, Ireland;

[2] Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland;Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;

[3] Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland;School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;

[4] Emergency Department, Cork University Hospital, Cork, Ireland;

[5] School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;ALERT Limerick EM Education Research Training, Emergency Department, University Hospital Limerick, Limerick, Ireland;

[6] School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;SLÁINTE Research and Education Alliance in General Practice, Primary Healthcare and Public Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland;Department of Paramedicine, Monash University, Melbourne, Australia;

关键词: Emergency department utilisation;    Crowding;    COVID-19;    Access to care;    Emergency department operations;   

DOI  :  10.1186/s12873-022-00720-7

 received in 2022-04-24, accepted in 2022-08-30,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe collateral damage of SARS-CoV-2 is a serious concern in the Emergency Medicine (EM) community, specifically in relation to delayed care increasing morbidity and mortality in attendances unrelated to COVID-19. The objectives of this study are to describe the profile of patients attending an Irish ED prior to, and during the pandemic, and to investigate the factors influencing ED utilisation in this cohort.MethodsThis was a cross-sectional study with recruitment at three time-points prior to the onset of COVID-19 in December 2019 (n = 47) and February 2020 (n = 57) and post-Lockdown 1 in July 2020 (n = 70). At each time-point all adults presenting over a 24 h period were eligible for inclusion. Clinical data were collected via electronic records and a questionnaire provided information on demographics, healthcare utilisation, service awareness and factors influencing the decision to attend the ED. Data analysis was performed in SPSS and included descriptive and inferential statistics.ResultsThe demographic and clinical profile of patients across time-points was comparable in terms of age (p = 0.904), gender (p = 0.584) and presenting complaint (p = 0.556). Median length of stay in the ED decreased from 7.25 h (IQR 4.18–11.22) in February to 3.86 h (IQR 0.41–9.14) in July (p ≤ 0.005) and differences were observed in disposition (p ≤ 0.001). COVID-19 influenced decision to attend the ED for 31% of patients with 9% delaying presentation. Post-lockdown, patients were less likely to attend the ED for reassurance (p ≤ 0.005), for a second opinion (p ≤ 0.005) or to see a specialist (p ≤ 0.05).ConclusionsDemographic and clinical presentations of ED patients prior to the first COVID-19 lockdown and during the reopening phase were comparable, however, COVID-19 significantly impacted health-seeking behaviour and operational metrics in the ED at this phase of the pandemic. These findings provide useful information for hospitals with regard to pandemic preparedness and also have wider implications for planning of future health service delivery.

【 授权许可】

CC BY   
© The Author(s) 2022

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