When fear backfires: Emergency department accesses during the Covid-19 pandemic. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Garrafa, Emirena; Levaggi, Rosella; Miniaci, Raffaele; Paolillo, Ciro
• Is Part Of: Health policy. Volume 124:Issue 12(2020)
• Page Start: 1333
• Page End: 1339
• Publication Date: 2020-12
• Subjects: Covid-19 pandemic -- ED accesses -- Fear -- Patients behaviour -- Hospital reaction; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2020.10.006
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: We analyse accesses to ED of a large university hospital during COVID19 pandemic. Accesses have sharply decreased since the onset, for any triage code. ED was responsive to the crisis: median waiting time increased only marginally. Fear of contamination delayed accesses; patients may have suffered health loss. Patients ignored appeals not to use ED as first-contact for COVID related problems. Abstract: Introduction: The increase in access to Emergency Departments (ED) worldwide causes inefficiencies, but also signals its importance. The Coronavirus (Covid-19) outbreak allows to study the reactions of patients to the news about the spreading of the infection, which may have generated the fear that ED was no longer safe. Methods: We study access to ED of a large teaching hospital in Brescia - one of the most hit provinces in Italy by Covid-19 - during the pandemic (from the announcement of the first cases to the explosion of the pandemic, to months after end of the acute phase) to study how patients reacted to the news that ED could no longer be a safe place. We analyse triage code, mode of arrival to ED, and accesses related to chest and abdominal pain, to evaluate who was discouraged most. Results: Accesses have drastically reduced immediately after the news of the first contagion. During the lockdown accesses and admissions to hospital ward have decreased; this may mean that some patients may have suffered reduced health or increased mortality risks because of this decision. At the end of June accesses to ED and admissions to hospital ward are still lower than usual. Discussion: Fear of contagion and appeals not to use ED directly by Covid-19 patients may have discouraged access also for pressing health need.