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Exploration of Cardiology Patient Hospital Presentations, Health Care Utilisation and Cardiovascular Risk Factors
Kenneth Cho1, Giuseppe Femia2, Rosa Lee3
1Cardiology Department, Campbelltown Hospital, Sydney, NSW Australia; Western Sydney University, Sydney, NSW, Australia.
Insights
COVID-19 lockdowns reduced hospital visits but increased cardiology admission complexity and mortality. Patients reported fears and difficulties accessing healthcare, impacting cardiovascular risk factor control.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic and subsequent lockdowns significantly disrupted global healthcare delivery.
- This study examines the impact on cardiovascular services in Australian hospitals.
Purpose of the Study:
- To assess the effects of COVID-19 lockdowns on cardiovascular hospital admissions.
- To evaluate changes in community resource utilization and cardiovascular risk factor management.
- To analyze patient experiences and healthcare access during the pandemic.
Main Methods:
- A mixed-methods approach was employed, analyzing admissions data from a quaternary referral hospital.
- Cardiology admissions data (February 2018-July 2021) were compared pre- and post-lockdown.
- 299 patients were interviewed regarding healthcare resource use and risk factor control post-lockdown.
Main Results:
- Hospital presentations decreased (138,099 to 128,030), as did cardiology admissions (4,951 to 4,390).
- Cardiology admissions showed increased complexity (18.7% to 20.3%) and in-hospital mortality (2.3% to 2.8%) post-lockdown.
- 27% of patients delayed care due to COVID-19 fears; 19% faced difficulties accessing medical care, and 25% reduced physical activity.
Conclusions:
- COVID-19 lockdowns led to fewer hospital presentations but more complex cardiology cases with higher mortality.
- Patient-reported fear of COVID-19 and reduced access to community health services were significant challenges.
- The findings highlight the need for strategies to maintain cardiovascular care during public health crises.
Objectives:
COVID-19 and the lockdowns have affected health care provision internationally, including medical procedures and methods of consultation. We aimed to assess the impact of COVID-19 at two Australian hospitals, focussing on cardiovascular hospital admissions, the use of community resources and cardiovascular risk factor control through a mixed methods approach.
Methods:
Admissions data from the quaternary referral hospital were analysed, and 299 patients were interviewed from July 2020 to December 2021. With the admissions data, the number, complexity and mortality of cardiology hospital admissions, prior to the first COVID-19 lockdown (T0=February 2018-July 2019) were compared to after the introduction of COVID-19 lockdowns (T1=February 2020-July 2021). During interviews, we asked patients about hospital and community health resource use, and their control of cardiovascular risk factors from the first lockdown.
Results:
Admission data showed a reduction in hospital presentations (T0=138,099 vs T1=128,030) and cardiology admissions after the lockdown period began (T0=4,951 vs T1=4,390). After the COVID-19-related lockdowns began, there was an increased complexity of cardiology admissions (T0=18.7%, 95% CI 17.7%-19.9% vs T1=20.3%, 95% CI 19.1%-21.5%, chi-square test: 4,158.658, p<0.001) and in-hospital mortality (T0=2.3% of total cardiology admissions 95% CI 1.9%-2.8% vs T1=2.8%, 95% CI 2.3%-3.3%, chi-square test: 4,060.217, p<0.001). In addition, 27% of patients delayed presentation due to fears of COVID-19 while several patients reported reducing their general practitioner or pathology/imaging appointments (27% and 11% respectively). Overall, 19% reported more difficulty accessing medical care during the lockdown periods. Patients described changes in their cardiovascular risk factors, including 25% reporting reductions in physical activity.
Conclusion:
We found a decrease in hospital presentations but with increased complexity after the introduction of COVID-19 lockdowns. Patients reported being fearful about presenting to hospital and experiencing difficulty in accessing community health services.
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