Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
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...
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e049222.full |
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| author | D Campbell Mark Tacey Adam Ivan Semciw Brian Oldenburg Rebecca Leigh Jessup Y Cao M Kirk C Bramston A Beauchamp A Gust N Cvetanovska C Haywood P Conilione Beverley Copnell H Mehdi Dialla Alnasralah Emilliano Zucchi A Trezona T Haregu K Stockman |
| author_facet | D Campbell Mark Tacey Adam Ivan Semciw Brian Oldenburg Rebecca Leigh Jessup Y Cao M Kirk C Bramston A Beauchamp A Gust N Cvetanovska C Haywood P Conilione Beverley Copnell H Mehdi Dialla Alnasralah Emilliano Zucchi A Trezona T Haregu K Stockman |
| author_sort | D Campbell |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-138a6e8725b84ca48c54cdbed9d62048 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-138a6e8725b84ca48c54cdbed9d620482025-08-20T02:21:04ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-049222Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods studyD Campbell0Mark Tacey1Adam Ivan Semciw2Brian Oldenburg3Rebecca Leigh Jessup4Y Cao5M Kirk6C Bramston7A Beauchamp8A Gust9N Cvetanovska10C Haywood11P Conilione12Beverley Copnell13H Mehdi14Dialla Alnasralah15Emilliano Zucchi16A Trezona17T Haregu18K Stockman193Great North Children’s Hospital, NE1 4L, UKOffice of Research, Northern Health, Epping, Victoria, AustraliaAllied Health, Northern Health, Epping, Victoria, AustraliaBaker Heart and Diabetes Institute, Melbourne, Victoria, AustraliaSchool of Allied Health, Human Services and Sport, LaTrobe University, Bundoora, Victoria, AustraliaSchool of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Medicine, Rockhampton Hospital, Rockhampton, Queensland, AustraliaAllied Health, Northern Health, Epping, Victoria, AustraliaSchool of Rural Health, Monash University, Warrigal, Victoria, AustraliaStaying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, AustraliaSchool of Rural Health, Monash University, Warrigal, Victoria, AustraliaStaying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, AustraliaStaying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, AustraliaSchool of Nursing and Midwifery, LaTrobe University, Melbourne, Victoria, AustraliaOffice of Research, Northern Health, Epping, Victoria, AustraliaOffice of Research, Northern Health, Epping, Victoria, AustraliaTranscultural and Language Services, Northern Health, Melbourne, Victoria, AustraliaTrezona Consulting Group, Brunswick, Victoria, AustraliaSchool of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaStaying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, AustraliaObjectives 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.https://bmjopen.bmj.com/content/11/12/e049222.full |
| spellingShingle | D Campbell Mark Tacey Adam Ivan Semciw Brian Oldenburg Rebecca Leigh Jessup Y Cao M Kirk C Bramston A Beauchamp A Gust N Cvetanovska C Haywood P Conilione Beverley Copnell H Mehdi Dialla Alnasralah Emilliano Zucchi A Trezona T Haregu K Stockman Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study BMJ Open |
| title | Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study |
| title_full | Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study |
| title_fullStr | Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study |
| title_full_unstemmed | Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study |
| title_short | Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study |
| title_sort | impact of covid 19 on emergency department attendance in an australia hospital a parallel convergent mixed methods study |
| url | https://bmjopen.bmj.com/content/11/12/e049222.full |
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