Open AccessFactors reducing inappropriate attendances to emergency departments before and during the COVID-19 pandemic: A multicentre study
Author(s) -
Lee Cheng,
William Ng,
Ziwei Lin,
Lawrence Siu-Chun Law,
Lorraine Yong,
Yi Song Terence Liew,
Chew Kiat Yeoh,
Ian Mathews,
Wei Ping Daniel Chor,
Win Sen Kuan
Publication year - 2021
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.2021151
Subject(s) - medicine , confidence interval , odds ratio , pandemic , covid-19 , emergency department , attendance , logistic regression , retrospective cohort study , emergency medicine , pediatrics , cluster (spacecraft) , disease , psychiatry , infectious disease (medical specialty) , economics , economic growth , computer science , programming language
Inappropriate attendances (IAs) to emergency departments (ED) create an unnecessarystrain on healthcare systems. With decreased ED attendance during the COVID-19 pandemic, this studypostulates that there are less IAs compared to before the pandemic and identifies factors associatedwith IAs.Methods: We performed a retrospective review of 29,267 patient presentations to a healthcare clusterin Singapore from 7 April 2020 to 1 June 2020, and 36,370 patients within a corresponding periodin 2019. This time frame coincided with local COVID-19 lockdown measures. IAs were defined aspatient presentations with no investigations required, with patients eventually discharged from the ED.IAs in the 2020 period during the pandemic were compared with 2019. Multivariable logistic regressionwas performed to identify factors associated with IAs.Results: There was a decrease in daily IAs in 2020 compared to 2019 (9.91±3.06 versus 24.96±5.92,P<0.001). IAs were more likely with self-referrals (adjusted odds ratio [aOR] 1.58, 95% confidenceinterval [CI] 1.50–1.66) and walk-ins (aOR 4.96, 95% CI 4.59–5.36), and those diagnosed withnon-specific headache (aOR 2.08, 95% CI 1.85–2.34), or non-specific low back pain (aOR 1.28, 95%CI 1.15–1.42). IAs were less likely in 2020 compared to 2019 (aOR 0.67, 95% CI 0.65–0.71) and olderpatients (aOR 0.79 each 10 years, 95% CI 0.78–0.80).Conclusion: ED IAs decreased during COVID-19. The pandemic has provided a unique opportunityto examine factors associated with IAs.Keywords: COVID-19, emergency department, inappropriate attendance, utilisation