Sutherland Kim, Chessman Julia, Zhao Jiaying, Sara Grant, Shetty Amith, Smith Sharon, Went Allan, Dyson Sophie, Levesque Jean-Frédéric
Agency for Clinical Innovation, Sydney, NSW, Australia;
Agency for Clinical Innovation, Sydney, NSW, Australia.
Public Health Res Pract. 2020 Dec 9;30(4):3042030. doi: 10.17061/phrp3042030.
COVID-19 has left no healthcare system untouched. In New South Wales (NSW), the most populous state in Australia, COVID-19 case numbers have to date been relatively low. However, that does not mean the state's healthcare system has been unaffected. Preparations to create sufficient capacity to accommodate a COVID-19 surge resulted in widespread deferment of scheduled medical procedures and appointments. Patterns of healthcare-seeking behaviour changed, with a reluctance to visit healthcare settings. The aim of this study was to quantify the changes in activity seen in the NSW health system in the first half of 2020.
Healthcare data were drawn from multiple sources, including primary care, ambulance, emergency departments and inpatient settings. Volumes of healthcare activity in 2020, overall, by urgency of cases and by reasons for care were compared with the figures for the same period in 2019. Changes in the modality of care provision were also examined.
In March to June 2020, compared with the same period in 2019, primary care face-to-face consultations decreased by 22.1%, breast screening activity by 51.5%, ambulance incidents by 7.2%, emergency department visits by 13.9%, public hospital inpatient episodes by 14.3%, and public hospital planned surgical activity by 32.6%.
There were substantial declines in a wide range of healthcare activities across the NSW health system between March and June 2020 due to the impact of the COVID-19 pandemic. Although activity levels were recovering by September 2020, they had not yet returned to 'normal'. The implications of these changes - and the indirect impact of COVID-19 - require further study.
新冠疫情已波及所有医疗系统。在澳大利亚人口最多的新南威尔士州(NSW),截至目前新冠病例数相对较少。然而,这并不意味着该州的医疗系统未受影响。为创造足够能力以应对新冠疫情高峰所做的准备工作导致大量预定医疗程序和预约被推迟。就医行为模式发生改变,人们不愿前往医疗机构。本研究的目的是量化2020年上半年新南威尔士州医疗系统中所观察到的活动变化。
医疗数据来自多个来源,包括初级保健、救护车、急诊科和住院部。将2020年的医疗活动总量、按病例紧急程度和就医原因分类的活动量与2019年同期数据进行比较。还研究了护理提供方式的变化。
与2019年同期相比,2020年3月至6月,初级保健面对面咨询减少了22.1%,乳房筛查活动减少了51.5%,救护车事件减少了7.2%,急诊科就诊减少了13.9%,公立医院住院病例减少了l4.3%,公立医院计划内手术活动减少了32.6%。
由于新冠疫情的影响,2020年3月至6月期间新南威尔士州医疗系统中多种医疗活动大幅下降。尽管到2020年9月活动水平有所恢复,但尚未恢复到“正常”水平。这些变化的影响以及新冠疫情的间接影响需要进一步研究。