Department of Innovation and Research, Nuvance Health, Danbury, CT, United States of America.
Department of Innovation and Research, Nuvance Health, Danbury, CT, United States of America.
Am J Emerg Med. 2021 Sep;47:164-168. doi: 10.1016/j.ajem.2021.03.084. Epub 2021 Mar 31.
The outbreak of COVID-19 disrupted lives across the United States. Evidence shows that such a climate is deleterious to mental health and may increase demand for mental health services in emergency departments. The purpose of this study was to determine the difference in emergency department utilization for mental health diagnoses before and after the COVID-19 surge.
We conducted a cross-sectional study between January-August 2019 and January-August 2020 with emergency department encounter as the sampling unit. The primary outcome was the proportion of all emergency department encounters attributed to mental health. We performed chi-square analyses to evaluate the differences between 2019 and 2020.
We found that overall emergency department volume declined between 2019 and 2020, while the proportion attributable to mental health conditions increased (p < 0.01). Substance abuse, anxiety, and mood disorders accounted for nearly 90% of mental health diagnoses during both periods. When stratified by sex, substance abuse was the leading mental health diagnosis for males and anxiety and substance abuse disorders combined accounted for the largest proportion for females.
The emergency department is an important community resource for the identification and triage of mental health emergencies. This role is even more important during disasters and extended crises, making it imperative that emergency departments employ experienced mental health staff. This study provides a comparison of emergency department utilization for mental health diagnoses before the pandemic and during the spring 2020 surge and may serve as a useful guide for hospitals, health systems and communities in future planning.
COVID-19 疫情在美国各地扰乱了人们的生活。有证据表明，这种情况对心理健康有害，并可能增加急诊科对心理健康服务的需求。本研究的目的是确定 COVID-19 疫情爆发前后，急诊部门因心理健康诊断而就诊的差异。
我们进行了一项横断面研究，时间为 2019 年 1 月至 8 月和 2020 年 1 月至 8 月，以急诊就诊为抽样单位。主要结局是归因于心理健康的所有急诊就诊比例。我们进行了卡方分析，以评估 2019 年和 2020 年之间的差异。
我们发现，2019 年至 2020 年期间，总体急诊量下降，而归因于心理健康状况的比例增加（p<0.01）。药物滥用、焦虑和情绪障碍在两个时期占心理健康诊断的近 90%。按性别分层，药物滥用是男性的主要心理健康诊断，而焦虑和药物滥用障碍的综合占女性的最大比例。
急诊科是识别和分诊心理健康紧急情况的重要社区资源。在灾难和长期危机期间，这一角色更为重要，因此急诊科必须聘请有经验的心理健康工作人员。本研究比较了大流行前和 2020 年春季疫情期间急诊科因心理健康诊断而就诊的情况，可为医院、卫生系统和社区在未来规划中提供有用的指导。
