Health Intelligence Team, Public Health Directorate, Adults and Health, Lambeth Council, London SW2 1EG, UK.
Emergency Department, King's College Hospital NHS Foundation Trust London, London SE5 9RS, UK.
J Public Health (Oxf). 2021 Dec 10;43(4):731-738. doi: 10.1093/pubmed/fdab059.
Concerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown.
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.
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.
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.
人们担心在 2019 冠状病毒病（COVID-19）封锁期间，需要紧急护理的患者可能无法获得医疗服务。
本病例对照研究旨在了解在 COVID-19 大流行的第一波（2020 年 3 月至 5 月）期间，与 2019 年同期相比，英国一家大型急诊部（ED）就诊患者的特征和诊断变化。
我们发现 2020 年 ED 的首次就诊量下降了 50.7%。就诊和入院的可能性降低了儿科患者和≥46 岁患者，以及男性患者。所有黑人种族群体和来自最贫困程度多重剥夺五分位数的患者入院的可能性增加。这种向年龄更大、男性更多、贫困程度更高、少数民族群体代表性更高的患者人群的转变，在“感染”诊断类别中更为明显。
COVID-19 对 ED 的使用产生了巨大影响。我们的分析有助于当地资源规划，并了解大流行期间医疗保健寻求行为的变化。未来的研究可以识别积极的行为变化，从而有助于在长期内减少非紧急就诊。
