Institute for Transport Studies and Choice Modelling Centre, University of Leeds, Leeds, UK
Institute for Transport Studies and Choice Modelling Centre, University of Leeds, Leeds, UK.
Emerg Med J. 2023 Jul;40(7):518-524. doi: 10.1136/emermed-2021-212058. Epub 2023 Apr 26.
The COVID-19 pandemic has been linked to a sharp drop in ED attendance, but the exact reasons for this are unclear. The aim of this study was to investigate differences between individuals attending the ED before and during the pandemic and the reasons for their choices.
Two population-based online surveys were conducted before (2019) and during (2020) the pandemic. Participants were recruited by a survey panel to be representative of the UK population aged 18-45 years. Both surveys asked about the circumstances and reasons for the last ED attendance, with specific pandemic-related questions in the second one. Comparisons of characteristics and symptoms of individuals attending during the pandemic were compared with those attending in prior years using χ tests. We determined the proportion of patients who had symptoms during the pandemic but did not attend, and the reasons for that choice.
Young and high-income people, those with chronic illnesses and those with influenza-like symptoms were more likely to attend the ED during lockdown than before. 18% of respondents had experienced urgent symptoms during the pandemic; 60% of these individuals chose not to go to the ED. While about 30% of this group stated they believed their symptoms were not serious enough, 85% of these individuals mentioned fear of infection or worry about overburdening the system as a reason for not attending. Individuals attending during the pandemic were more likely to consider their visit unnecessary compared with those attending previously.
The study suggests that the decision to use the ED has a discretionary component. This could potentially contribute to unnecessary visits, and raises concerns that some patients who should present at the ED do not go. More effective communication about who should visit EDs during a pandemic, and the safety of doing so, is needed.
COVID-19 大流行导致急诊科就诊人数急剧下降，但具体原因尚不清楚。本研究旨在调查大流行前后前往急诊科就诊的个体之间的差异及其就诊原因。
在大流行之前（2019 年）和期间（2020 年）进行了两次基于人群的在线调查。通过调查小组招募参与者，以代表英国 18-45 岁人群。两项调查均询问了最近一次去急诊科就诊的情况和原因，并在第二次调查中询问了与大流行相关的特定问题。使用 χ2 检验比较大流行期间就诊者与前几年就诊者的特征和症状。确定了在大流行期间出现症状但未就诊的患者比例以及未就诊的原因。
与大流行前相比，年轻人和高收入人群、患有慢性病的人群以及出现流感样症状的人群在封锁期间更有可能去急诊科就诊。18%的受访者在大流行期间出现了紧急症状；其中 60%的人选择不去急诊科就诊。虽然该组约 30%的人表示他们认为自己的症状不严重，但其中 85%的人提到担心感染或担心给系统带来过重负担是不去就诊的原因。与大流行前就诊者相比，大流行期间就诊者更有可能认为自己的就诊是不必要的。
该研究表明，使用急诊科就诊的决定具有可自由裁量的成分。这可能导致不必要的就诊，并且令人担忧的是，一些应该到急诊科就诊的患者没有去就诊。在大流行期间，需要更有效地沟通谁应该去急诊科就诊，以及这样做的安全性。
