Field Service, UK Health Security Agency, Bristol, BS1 6EH, UK.
National Institute of Health Research Health Protection Research Unit on Behavioural Science and Evaluation at the University of Bristol, Bristol, UK.
BMC Public Health. 2021 Nov 5;21(1):2019. doi: 10.1186/s12889-021-12117-5.
Since the end of January 2020, the coronavirus (COVID-19) pandemic has been responsible for a global health crisis. In England a number of non-pharmaceutical interventions have been introduced throughout the pandemic, including guidelines on healthcare attendance (for example, promoting remote consultations), increased handwashing and social distancing. These interventions are likely to have impacted the incidence of non-COVID-19 conditions as well as healthcare seeking behaviour. Syndromic Surveillance Systems offer the ability to monitor trends in healthcare usage over time.
This study describes the indirect impact of COVID-19 on healthcare utilisation using a range of syndromic indicators including eye conditions, mumps, fractures, herpes zoster and cardiac conditions. Data from the syndromic surveillance systems monitored by Public Health England were used to describe the number of contacts with NHS 111, general practitioner (GP) In Hours (GPIH) and Out-of-Hours (GPOOH), Ambulance and Emergency Department (ED) services over comparable periods before and during the pandemic.
The peak pandemic period in 2020 (weeks 13-20), compared to the same period in 2019, displayed on average a 12% increase in NHS 111 calls, an 11% decrease in GPOOH consultations, and a 49% decrease in ED attendances. In the GP In Hours system, conjunctivitis consultations decreased by 64% and mumps consultations by 31%. There was a 49% reduction in attendance at EDs for fractures, and there was no longer any weekend increase in ED fracture attendances, with similar attendance patterns observed across each day of the week. There was a decrease in the number of ED attendances with diagnoses of myocardial ischaemia.
The COVID-19 pandemic drastically impacted healthcare utilisation for non-COVID-19 conditions, due to a combination of a probable decrease in incidence of certain conditions and changes in healthcare seeking behaviour. Syndromic surveillance has a valuable role in describing and understanding these trends.
自 2020 年 1 月底以来，冠状病毒（COVID-19）大流行导致了全球卫生危机。在英国，整个大流行期间都引入了多项非药物干预措施，包括医疗保健就诊指南（例如，提倡远程咨询），增加洗手和保持社交距离。这些干预措施可能会对非 COVID-19 疾病的发病率和医疗保健寻求行为产生影响。症状监测系统提供了随时间监测医疗保健使用趋势的能力。
本研究使用一系列症状指标（包括眼部疾病、腮腺炎、骨折、带状疱疹和心脏疾病）描述了 COVID-19 对医疗保健利用的间接影响。使用英国公共卫生监测的症状监测系统的数据，描述了在大流行前后可比时期内与 NHS 111、全科医生（GP）In Hours（GPIH）和 Out-of-Hours（GPOOH）、救护车和急症部门（ED）的联系次数。
与 2019 年同期相比，2020 年的大流行高峰期（第 13-20 周），NHS 111 电话呼叫平均增加了 12%，GPOOH 咨询减少了 11%，ED 就诊人数减少了 49%。在 GP In Hours 系统中，结膜炎就诊减少了 64%，腮腺炎就诊减少了 31%。ED 骨折就诊人数减少了 49%，周末 ED 骨折就诊人数不再增加，每周每天的就诊模式相似。ED 心肌缺血诊断的就诊人数减少。
由于某些疾病发病率的可能下降和医疗保健寻求行为的变化，COVID-19 大流行对非 COVID-19 疾病的医疗保健利用产生了巨大影响。症状监测在描述和理解这些趋势方面具有重要作用。
