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COVID-19 大流行的更广泛影响:评估急诊频繁就诊者使用的影响。

The wider implications of the COVID-19 pandemic: Assessing the impact of accident and emergency use for frequent attenders.

机构信息

NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, United Kingdom; School of Medicine, Dentistry and Nursing, University of Glasgow, United Kingdom.

School of Medicine, Dentistry and Nursing, University of Glasgow, United Kingdom.

出版信息

Int Emerg Nurs. 2021 May;56:100984. doi: 10.1016/j.ienj.2021.100984. Epub 2021 Feb 20.

Abstract

INTRODUCTION

Emergency departments have seen altered patterns of attendance since the beginning of the COVID-19 pandemic, with reductions in the number of attendances for non-COVID-19 - patients. We assessed the use of the emergency department by frequent attenders during the height of the COVID-19 pandemic and explored any changes in emergency department attendance by this group.

METHODS

As part of ongoing improvement work, we utilised a cohort design to evaluate the difference in patterns of attendance for the frequent attender group in a single centre. We created a 2019 'top attender' cohort and a similar cohort for 2020. We compared admission patterns between the two time periods in order to understand the impact of the COVID-19 pandemic on this group.

RESULTS

Both groups were predominately male. Mental health and substance misuse use problems were common across both cohorts. The majority of patients lived in a socio-economically deprived areas. The median number emergency department visits in 2019, for the top attender cohort was 6 (IQR: 4-9) vs 4 (IQR: 2-7) for the top attender cohort of 2020 (p < .0013).

CONCLUSION

This single centre evaluation has shown a significant reduction in emergency department attendances for a frequent attender cohort in a single centre. Future work should investigate the longer-term impact which the COVID-19 pandemic has had on this patient group.

摘要

简介

自 COVID-19 大流行开始以来,急诊科的就诊模式发生了变化,非 COVID-19 患者的就诊人数减少。我们评估了 COVID-19 大流行高峰期频繁就诊者对急诊科的使用情况,并探讨了该人群对急诊科就诊的任何变化。

方法

作为持续改进工作的一部分,我们利用队列设计评估了单一中心频繁就诊者群体的就诊模式差异。我们创建了 2019 年的“顶级就诊者”队列和 2020 年的类似队列。我们比较了两个时间段的入院模式,以了解 COVID-19 大流行对该群体的影响。

结果

两个队列均以男性为主。精神健康和药物滥用问题在两个队列中都很常见。大多数患者居住在社会经济贫困地区。2019 年,顶级就诊者队列的急诊就诊中位数为 6(IQR:4-9),而 2020 年顶级就诊者队列的中位数为 4(IQR:2-7)(p<0.0013)。

结论

这项单中心评估表明,单中心频繁就诊者的急诊科就诊人数显著减少。未来的工作应调查 COVID-19 大流行对这一患者群体的长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd78/7896822/692eec60916b/gr1_lrg.jpg

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