Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions
Dublin Core
Title
Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions
Subject
COVID-19, Emergency department, Acute medicine, Hospital admissions, Non-COVID-19 disease
Description
Background: To better understand the impact of the COVID-19 pandemic on hospital healthcare, we studied
activity in the emergency department (ED) and acute medicine department of a major UK hospital.
Methods: Electronic patient records for all adult patients attending ED (n = 243,667) or acute medicine (n = 82,899)
during the pandemic (2020–2021) and prior year (2019) were analysed and compared. We studied parameters
including severity, primary diagnoses, co-morbidity, admission rate, length of stay, bed occupancy, and mortality,
with a focus on non-COVID-19 diseases.
Results: During the first wave of the pandemic, daily ED attendance fell by 37%, medical admissions by 30% and
medical bed occupancy by 27%, but all returned to normal within a year. ED attendances and medical admissions fell
across all age ranges; the greatest reductions were seen for younger adults in ED attendances, but in older adults for
medical admissions. Compared to non-COVID-19 pandemic admissions, COVID-19 admissions were enriched for
minority ethnic groups, for dementia, obesity and diabetes, but had lower rates of malignancy. Compared to the prepandemic period, non-COVID-19 pandemic admissions had more hypertension, cerebrovascular disease, liver disease,
and obesity. There were fewer low severity ED attendances during the pandemic and fewer medical admissions across
all severity categories. There were fewer ED attendances with common non-respiratory illnesses including cardiac
diagnoses, but no change in cardiac arrests. COVID-19 was the commonest diagnosis amongst medical admissions
during the first wave and there were fewer diagnoses of pneumonia, myocardial infarction, heart failure, cellulitis,
chronic obstructive pulmonary disease, urinary tract infection and other sepsis, but not stroke. Levels had rebounded
by a year later with a trend to higher levels of stroke than before the pandemic. During the pandemic first wave, 7-day
mortality was increased for ED attendances, but not for non-COVID-19 medical admissions.
Conclusions: Reduced ED attendances in the first wave of the pandemic suggest opportunities for reducing low
severity presentations to ED in the future, but also raise the possibility of harm from delayed or missed care.
Reassuringly, recent rises in attendance and admissions indicate that any deterrent effect of the pandemic on
attendance is diminishing.
activity in the emergency department (ED) and acute medicine department of a major UK hospital.
Methods: Electronic patient records for all adult patients attending ED (n = 243,667) or acute medicine (n = 82,899)
during the pandemic (2020–2021) and prior year (2019) were analysed and compared. We studied parameters
including severity, primary diagnoses, co-morbidity, admission rate, length of stay, bed occupancy, and mortality,
with a focus on non-COVID-19 diseases.
Results: During the first wave of the pandemic, daily ED attendance fell by 37%, medical admissions by 30% and
medical bed occupancy by 27%, but all returned to normal within a year. ED attendances and medical admissions fell
across all age ranges; the greatest reductions were seen for younger adults in ED attendances, but in older adults for
medical admissions. Compared to non-COVID-19 pandemic admissions, COVID-19 admissions were enriched for
minority ethnic groups, for dementia, obesity and diabetes, but had lower rates of malignancy. Compared to the prepandemic period, non-COVID-19 pandemic admissions had more hypertension, cerebrovascular disease, liver disease,
and obesity. There were fewer low severity ED attendances during the pandemic and fewer medical admissions across
all severity categories. There were fewer ED attendances with common non-respiratory illnesses including cardiac
diagnoses, but no change in cardiac arrests. COVID-19 was the commonest diagnosis amongst medical admissions
during the first wave and there were fewer diagnoses of pneumonia, myocardial infarction, heart failure, cellulitis,
chronic obstructive pulmonary disease, urinary tract infection and other sepsis, but not stroke. Levels had rebounded
by a year later with a trend to higher levels of stroke than before the pandemic. During the pandemic first wave, 7-day
mortality was increased for ED attendances, but not for non-COVID-19 medical admissions.
Conclusions: Reduced ED attendances in the first wave of the pandemic suggest opportunities for reducing low
severity presentations to ED in the future, but also raise the possibility of harm from delayed or missed care.
Reassuringly, recent rises in attendance and admissions indicate that any deterrent effect of the pandemic on
attendance is diminishing.
Creator
Michael E. Reschen, Jordan Bowen, Alex Novak, Matthew Giles, Sudhir Singh, Daniel Lasserson and Christopher A. O’Callaghan
Publisher
BMC Emergency Medicine
Date
(2021) 21:143
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Michael E. Reschen, Jordan Bowen, Alex Novak, Matthew Giles, Sudhir Singh, Daniel Lasserson and Christopher A. O’Callaghan, “Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/3903.