2021 Blanaid Canavan

Blanaid Canavan

Medical Registrar, Basic Physician Trainee, Aspiring Cardiologist, Irish fiddler

Where Have All The Patients Gone? Effects Of COVID-19 On ED Presentations And Medical Admissions In Redland Hospital

Aims
The aim of this study is to determine the effects of COVID-19 on medical admissions and emergency department presentations at Redland Hospital for the month following social distancing restrictions.

Methods
This single-site retrospective observational cohort study was undertaken in a small suburban hospital in Queensland, Australia. A Sample size of 200 patients from 24th March-24th April in 2019 & 2020. We used electronic record systems to generate Emergency department (ED) presentations including triage category, length of stay in ED, and ‘did not wait’. Information on medical admissions including co-morbidities, demographics and outcomes was obtained by reviewing patient charts.

Results
Total presentations to ED in the study period reduced by 18% in 2020 compared to 2019 (4707 in 2019 vs 3860 in 2020). Less patients were triaged as category 2 (21.6% in 2019 vs. 16.1% in 2020, p<0.001). Less patients ‘did not wait’ to be seen in 2020 compared to 2019 (72 patients (1.6%) in 2019 vs. 35 patients (0.9%) in 2020, p= 0.009). Medically admitted patients spent an extra night on the ward in 2020 compared to 2019 (p=0.0015). However, the same proportion of patients presenting to ED got medically admitted, despite ED presentations decreasing.

Conclusions
Decreased total number of patients presenting to ED may suggest social distancing and isolation reduce communicable disease, along with decreased injury-prone activity ( e.g. driving and sports). Healthy anxiety (fear of catching COVID-19) may also have contributed to decreased presentations to ED. This study raises questions regarding social distancing decreasing spread of communicable diseases and factors influencing the medical admissions. Future research should examine factors influencing medical admission in hospital. It is hoped that the information from this research will assist to inform and develop future research on ways to decrease presentations to ED and reduce medical admissions.