Cardiology Department, Campbelltown Hospital, Sydney, NSW Australia; Western Sydney University, Sydney, NSW, Australia.
Cardiology Department, Campbelltown Hospital, Sydney, NSW Australia; Western Sydney University, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia.
Heart Lung Circ. 2023 Mar;32(3):348-352. doi: 10.1016/j.hlc.2022.11.013. Epub 2023 Jan 3.
COVID-19 and the lockdowns have affected health care provision internationally, including medical procedures and methods of consultation. We aimed to assess the impact of COVID-19 at two Australian hospitals, focussing on cardiovascular hospital admissions, the use of community resources and cardiovascular risk factor control through a mixed methods approach.
Admissions data from the quaternary referral hospital were analysed, and 299 patients were interviewed from July 2020 to December 2021. With the admissions data, the number, complexity and mortality of cardiology hospital admissions, prior to the first COVID-19 lockdown (T0=February 2018-July 2019) were compared to after the introduction of COVID-19 lockdowns (T1=February 2020-July 2021). During interviews, we asked patients about hospital and community health resource use, and their control of cardiovascular risk factors from the first lockdown.
Admission data showed a reduction in hospital presentations (T0=138,099 vs T1=128,030) and cardiology admissions after the lockdown period began (T0=4,951 vs T1=4,390). After the COVID-19-related lockdowns began, there was an increased complexity of cardiology admissions (T0=18.7%, 95% CI 17.7%-19.9% vs T1=20.3%, 95% CI 19.1%-21.5%, chi-square test: 4,158.658, p<0.001) and in-hospital mortality (T0=2.3% of total cardiology admissions 95% CI 1.9%-2.8% vs T1=2.8%, 95% CI 2.3%-3.3%, chi-square test: 4,060.217, p<0.001). In addition, 27% of patients delayed presentation due to fears of COVID-19 while several patients reported reducing their general practitioner or pathology/imaging appointments (27% and 11% respectively). Overall, 19% reported more difficulty accessing medical care during the lockdown periods. Patients described changes in their cardiovascular risk factors, including 25% reporting reductions in physical activity.
We found a decrease in hospital presentations but with increased complexity after the introduction of COVID-19 lockdowns. Patients reported being fearful about presenting to hospital and experiencing difficulty in accessing community health services.
COVID-19 和封锁措施对国际医疗服务产生了影响，包括医疗程序和咨询方式。我们旨在通过混合方法评估 COVID-19 对澳大利亚两家医院的影响，重点关注心血管病住院、社区资源利用和心血管危险因素控制。
分析了四所转诊医院的入院数据，并于 2020 年 7 月至 2021 年 12 月对 299 名患者进行了访谈。通过入院数据，比较了 COVID-19 封锁前（T0：2018 年 2 月至 2019 年 7 月）和 COVID-19 封锁后（T1：2020 年 2 月至 2021 年 7 月）心脏病医院入院的数量、复杂性和死亡率。在访谈中，我们询问了患者在第一次封锁期间对医院和社区卫生资源的使用情况，以及他们对心血管危险因素的控制情况。
入院数据显示，封锁后医院就诊量（T0：138099 例，T1：128030 例）和心脏病入院量（T0：4951 例，T1：4390 例）减少。COVID-19 相关封锁开始后，心脏病入院的复杂性增加（T0：18.7%，95%CI 17.7%-19.9%；T1：20.3%，95%CI 19.1%-21.5%，卡方检验：4158.658，p<0.001），住院死亡率（T0：心脏病总入院人数的 2.3%，95%CI 1.9%-2.8%；T1：2.8%，95%CI 2.3%-3.3%，卡方检验：4060.217，p<0.001）增加。此外，27%的患者因担心 COVID-19 而延迟就诊，而一些患者报告减少了他们的全科医生或病理/影像预约（分别为 27%和 11%）。总体而言，19%的患者在封锁期间报告更难获得医疗服务。患者描述了他们心血管危险因素的变化，包括 25%的患者报告体力活动减少。
我们发现 COVID-19 封锁后，医院就诊人数减少，但复杂性增加。患者表示对住院感到恐惧，并报告在获得社区卫生服务方面存在困难。
