比较急诊科就诊的主要症状，探讨 COVID-19 大流行对老年人就医行为的影响。

Impact of the COVID-19 pandemic on medical-seeking behavior in older adults by comparing the presenting complaints of the emergency department visits.

机构信息

Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan.

School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.

出版信息

BMC Emerg Med. 2023 Jun 6;23(1):63. doi: 10.1186/s12873-023-00819-5.

DOI:10.1186/s12873-023-00819-5

PMID:37280535

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10243245/

Abstract

BACKGROUND

The outbreak of the coronavirus disease 2019 (COVID-19) has caused a catastrophic event worldwide. Since then, people's way of living has changed in terms of personal behavior, social interaction, and medical-seeking behavior, including change of the emergency department (ED) visiting patterns. The objective of this study was to analyze the impact of the COVID-19 pandemic on the ED visiting patterns of the older people to explore its variable expression with the intention of ameliorating an effective and suitable response to public health emergencies.

METHODS

This was a retrospective study conducted in three hospitals of the Cathay Health System in Taiwan. Patients aged ≥ 65 years who presented to the ED between January 21, 2020, and April 30, 2020 (pandemic stage), and between January 21, 2019, and April 30, 2019 (pre-pandemic stage) were enrolled in the study. Basic demographics, including visit characteristics, disposition, and chief complaints of the patients visiting the ED between these two periods of time, were compared and analyzed.

RESULTS

A total of 16,655 older people were included in this study. A 20.91% reduction in ED older adult patient visits was noted during the pandemic period. During the pandemic, there was a decrease in ambulance use among elderly patients visiting the ED, with the proportion decreasing from 16.90 to 16.58%. Chief complaints of fever, upper respiratory infections, psychological and social problems increased, with incidence risk ratios (IRRs) of 1.12, 1.23, 1.25, and 5.2, respectively. Meanwhile, the incidence of both non-life-threatening and life-threatening complaints decreased, with IRRs of 0.72 and 0.83, respectively.

CONCLUSION

Health education regarding life-threatening symptom signs among older adult patients and avocation of the proper timing to seek medical attention via ambulance were crucial issues during the pandemic.

摘要

背景

2019 年冠状病毒病（COVID-19）的爆发在全球范围内造成了灾难性事件。从那时起，人们的生活方式在个人行为、社会互动和就医行为方面发生了变化，包括急诊科（ED）就诊模式的改变。本研究的目的是分析 COVID-19 大流行对老年人 ED 就诊模式的影响，探讨其变量表达，旨在改善对突发公共卫生事件的有效和适当应对。

方法

这是一项在台湾国泰医疗系统的三家医院进行的回顾性研究。纳入 2020 年 1 月 21 日至 4 月 30 日（大流行阶段）和 2019 年 1 月 21 日至 4 月 30 日（大流行前阶段）期间到急诊科就诊且年龄≥65 岁的患者。比较分析了这两个时间段内患者的基本人口统计学特征，包括就诊特征、处置和主要诉求。

结果

本研究共纳入 16655 名老年人。大流行期间，ED 老年患者就诊人数减少了 20.91%。在大流行期间，前往 ED 的老年患者使用救护车的比例下降，从 16.90%降至 16.58%。发热、上呼吸道感染、心理和社会问题的主要诉求增加，风险比（IRR）分别为 1.12、1.23、1.25 和 5.2。同时，非危及生命和危及生命的投诉发生率均下降，IRR 分别为 0.72 和 0.83。