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Comparison of presentations to the emergency department during the COVID-19 pandemic (COPED-C)
A Kociejowski1, C Hobart1, R Jina2
1Health Intelligence Team, Public Health Directorate, Adults and Health, Lambeth Council, London SW2 1EG, UK.
Insights
During COVID-19 lockdowns, emergency department (ED) visits dropped significantly. The remaining patients were older, male, more deprived, and from ethnic minority groups, particularly for infection diagnoses.
Area of Science:
- Public Health
- Emergency Medicine
- Epidemiology
Background:
- Concerns exist regarding healthcare access for emergency care during the COVID-19 pandemic lockdown.
- The pandemic's impact on healthcare-seeking behaviors requires investigation.
Purpose of the Study:
- To analyze changes in patient demographics and diagnoses presenting to a UK Emergency Department (ED) during the first COVID-19 wave.
- To compare patient characteristics during March-May 2020 with the same period in 2019.
Main Methods:
- Case-control study design.
- Comparison of ED attendance data from March-May 2020 (COVID-19 wave) against equivalent weeks in 2019.
- Analysis of patient demographics, deprivation status, and diagnostic categories.
Main Results:
- A 50.7% decrease in ED attendances was observed in 2020.
- Attendance and admission likelihood decreased for pediatric patients but increased for adults aged 46+, and males.
- Admission likelihood rose for Black ethnic groups and patients from most deprived areas, especially within the 'Infections' category.
Conclusions:
- The COVID-19 pandemic significantly altered ED usage patterns.
- Findings inform local resource planning and understanding of pandemic-related healthcare-seeking behavior shifts.
- Future research should explore sustained reductions in non-urgent ED visits.
Background:
Concerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown.
Methods:
This case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March-May 2020) compared with equivalent weeks in 2019.
Results:
We found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the 'Infections' diagnostic category.
Conclusions:
COVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.
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