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. 2022 Feb;16(1):36-39.
doi: 10.1017/dmp.2020.303. Epub 2020 Aug 12.

Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect?

Dennis G Barten  1 , Gideon H P Latten  2 , Frits H M van Osch  3
Affiliations

Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect?

Dennis G Barten et al. Disaster Med Public Health Prep. 2022 Feb.

Abstract

Objective: Since the beginning of the coronavirus disease (COVID-19) pandemic, several frontline workers have expressed their concerns about reduced emergency department (ED) utilization. We aimed to examine the changes in ED utilization during the early phase of the COVID-19 pandemic, in a country with a well-developed primary care system.

Methods: A retrospective analysis of ED utilization was performed in 3 Dutch hospitals during a 60-day period, starting on February 15, 2020. The identical period in 2019 was used as a reference. ED visits were labeled as COVID-related (defined as COVID-19 suspected) or non-COVID-related. Admission rates were compared using chi-square tests, and the reduction in ED visits was assessed descriptively.

Results: During the study period, daily ED volume was 18% lower compared to that of 2019. ED utilization further declined (-29%) during lockdown. Combined admission rates were higher in 2020 compared to those in 2019 (P < 0.001), and they were higher for COVID-19 versus non-COVID-19 ED visits (P < 0.001).

Conclusions: ED utilization was markedly reduced during the local rise of COVID-19 in a region with a well-developed primary care system and relatively low ED self-referral rates. Although it cannot directly be concluded from the findings of our study, this observation likely reflects a complex interaction between pure lockdown effects and viral fear, which warrants further research.

Keywords: COVID-19; delivery of health care; emergency preparedness; emergency service hospital; pandemics.

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Figures

FIGURE 1
FIGURE 1
Emergency Department Utilization Pattern, Hospital 1.
FIGURE 2
FIGURE 2
Emergency Department Utilization Pattern, Hospital 2.
FIGURE 3
FIGURE 3
Emergency Department Utilization Pattern Hospitals Combined.
FIGURE 4
FIGURE 4
Emergency Department Utilization Pattern, Hospital 3.
See this image and copyright information in PMC

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