Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study.

Autor:	Jessup RL; Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Victoria, Australia rebecca.jessup@nh.org.au.; Allied Health, Northern Health, Epping, Victoria, Australia.; School of Rural Health, Monash University, Warrigal, Victoria, Australia.; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.; School of Allied Health, Human Services and Sport, LaTrobe University, Bundoora, Victoria, Australia., Bramston C; Allied Health, Northern Health, Epping, Victoria, Australia., Beauchamp A; School of Rural Health, Monash University, Warrigal, Victoria, Australia.; Department of Medicine - Western Health, The University of Melbourne, St Albans, Victoria, Australia., Gust A; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia., Cvetanovska N; School of Rural Health, Monash University, Warrigal, Victoria, Australia., Cao Y; School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Haywood C; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia., Conilione P; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia., Tacey M; Office of Research, Northern Health, Epping, Victoria, Australia., Copnell B; School of Nursing and Midwifery, LaTrobe University, Melbourne, Victoria, Australia., Mehdi H; Office of Research, Northern Health, Epping, Victoria, Australia., Alnasralah D; Office of Research, Northern Health, Epping, Victoria, Australia., Kirk M; Department of Medicine, Rockhampton Hospital, Rockhampton, Queensland, Australia., Zucchi E; Transcultural and Language Services, Northern Health, Melbourne, Victoria, Australia., Campbell D; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.; Faculty of Art, Design and Architecture, Monash University, Clayton, Victoria, Australia., Trezona A; Trezona Consulting Group, Brunswick, Victoria, Australia., Haregu T; School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Oldenburg B; School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia., Stockman K; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia.; Faculty of Art, Design and Architecture, Monash University, Clayton, Victoria, Australia., Semciw AI; Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Victoria, Australia.; Allied Health, Northern Health, Epping, Victoria, Australia.; School of Allied Health, Human Services and Sport, LaTrobe University, Bundoora, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Dec 30; Vol. 11 (12), pp. e049222. Date of Electronic Publication: 2021 Dec 30.
DOI:	10.1136/bmjopen-2021-049222
Abstrakt:	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. Competing Interests: Competing interests: All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three year, no other relationships or activities that could appear to have influenced the submitted work. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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