Emergency department presentations during the COVID-19 pandemic in Queensland (to June 2021): interrupted time series analysis

Article

Sweeny, Amy L, Keijzers, Gerben, Marshall, Andrea, Hall, Emma J, Ranse, Jamie, Zhang, Ping, Grant, Gary, Huang, Ya-Ling, Palipana, Dinesh, Teng, Yang D, Gerhard, Benjamin, Greenslade, Jaimi H, Jones, Philip and Crilly, Julia L. 2023. "Emergency department presentations during the COVID-19 pandemic in Queensland (to June 2021): interrupted time series analysis." Medical Journal of Australia. 218 (3), pp. 120-125. https://doi.org/10.5694/mja2.51819
Article Title

Emergency department presentations during the COVID-19 pandemic in Queensland (to June 2021): interrupted time series analysis

ERA Journal ID15323
Article CategoryArticle
AuthorsSweeny, Amy L, Keijzers, Gerben, Marshall, Andrea, Hall, Emma J, Ranse, Jamie, Zhang, Ping, Grant, Gary, Huang, Ya-Ling, Palipana, Dinesh, Teng, Yang D, Gerhard, Benjamin, Greenslade, Jaimi H, Jones, Philip and Crilly, Julia L
Journal TitleMedical Journal of Australia
Journal Citation218 (3), pp. 120-125
Number of Pages6
Year2023
PublisherJohn Wiley & Sons
Place of PublicationAustralia
ISSN0025-729X
1326-5377
Digital Object Identifier (DOI)https://doi.org/10.5694/mja2.51819
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.5694/mja2.51819
Abstract

Objectives
To assess emergency department (ED) presentation numbers in Queensland during the coronavirus disease 2019 (COVID-19) pandemic to mid-2021, a period of relatively low COVID-19 case numbers.

Design
Interrupted time series analysis.

Setting
All 105 Queensland public hospital EDs.

Main outcome measures
Numbers of ED presentations during the COVID-19 lockdown period (11 March 2020 – 30 June 2020) and the period of easing restrictions (1 July 2020 – 30 June 2021), compared with pre-pandemic period (1 January 2018 – 10 March 2020), overall (daily numbers) and by Australasian Triage Scale (ATS; daily numbers) and selected diagnostic categories (cardiac, respiratory, mental health, injury-related conditions) and conditions (stroke, sepsis) (weekly numbers).

Results
During the lockdown period, the mean number of ED presentations was 19.4% lower (95% confidence interval, –20.9% to –17.9%) than during the pre-pandemic period (predicted mean number: 5935; actual number: 4786 presentations). The magnitudes of the decline and the time to return to predicted levels varied by ATS category and diagnostic group; changes in presentation numbers were least marked for ATS 1 and 2 (most urgent) presentations, and for presentations with cardiac conditions or stroke. Numbers remained below predicted levels during the 12-month post-lockdown period for ATS 5 (least urgent) presentations and presentations with mental health problems, respiratory conditions, or sepsis.

Conclusions
The COVID-19 pandemic and related public restrictions were associated with profound changes in health care use. Pandemic plans should include advice about continuing to seek care for serious health conditions and health emergencies, and support alternative sources of care for less urgent health care needs.

Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420299. Epidemiology not elsewhere classified
420501. Acute care
420699. Public health not elsewhere classified
Byline AffiliationsGriffith University
Gold Coast Hospital and Health Service, Australia
Bond University
School of Nursing and Midwifery
Southern Cross University
Harvard Medical School, United States
Nepean Hospital Pathology, Australia
Royal Brisbane and Women’s Hospital, Australia
Queensland University of Technology
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