Abstract
Background: The coronavirus disease 2019 (COVID-19) has impacted the utilisation of Emergency Department (ED) services worldwide. This study aims to describe the changes in attendance at a single ED and corresponding patient visit characteristics before and during the COVID-19 period. Methods: In a single-centre retrospective cohort study, we used descriptive statistics to compare ED attendance, patient demographics and visit characteristics during the COVID-19 period (1 January–28 June 2020) and its corresponding historical period in 2019 (2 January–30 June 2019). Results: The mean ED attendance decreased from 342 visits/day in the pre-COVID-19 period to 297 visits/day in the COVID-19 period. This was accompanied by a decline in presentations in nearly every ICD-10-CM diagnosis category except for respiratory-related diseases. Notably, we observed reductions in visits by critically ill patients and severe disease presentations during the COVID-19 period. We also noted a shift in the ED patient case-mix from ‘Non-fever’ cases to ‘Fever’ cases, likely giving rise to two distinct trough-to-peak visit patterns during the pre-Circuit Breaker and Circuit Breaker period. Conclusions: This descriptive study revealed distinct ED visit trends across different time periods. The COVID-19 pandemic caused a reduction in ED attendances amongst patients with low-acuity conditions and those with highest priority for emergency care. This raises concern about treatment-seeking delays and the possible impact on health outcomes. The downward trend in low-acuity presentations also presents learning opportunities for ED crowd management planning in a post-COVID-19 era.
Highlights
Its Emergency Department (ED) sees approximately 130,000 patients annually [15]. In this retrospective cohort study, Singapore General Hospital (SGH) ED attendance, patient demographics and visit characteristics were reported during the COVID-19 period (1 January–28 June 2020)
A further exclusion of 4072 duplicate records and 12 distorted records left us with 115,096 ED visit records for the analysis; the pre-COVID-19 period had 61,576 visit records and the COVID-19 period had 53,520 visit records (Figure 1)
The decline in ED admissions was evident across all ward types except for the infectious disease or isolation wards during the COVID-19 period
Summary
The coronavirus disease 2019 (COVID-19) has impacted the utilisation of Emergency. Despite the surge in suspected COVID-19 cases, there is global evidence to show that the overall daily attendance at EDs has declined [1,2,3,4]. Singapore saw its first COVID-19 case on 23 January 2020. The coronavirus disease 2019 (COVID-19) has impacted the utilisation of Emergency Department (ED) services worldwide. This study aims to describe the changes in attendance at a single ED and corresponding patient visit characteristics before and during the COVID-19 period. Methods: In a single-centre retrospective cohort study, we used descriptive statistics to compare ED attendance, patient demographics and visit characteristics during the COVID-19 period (1 January–28 June 2020) and its corresponding historical period in 2019 (2 January–30 June 2019)
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