Objective: Emergency department (ED) visits have decreased to varying extents worldwide during the COVID-19 pandemic. This has been linked to restricted access to health services in association with the pandemic to changes in social life, and to individuals avoiding health institutions in order not to contract the disease. Failure to access emergency department services for health problems requiring urgent care can lead to complications and to outcomes even resulting in mortality and disability. The purpose of this study was to examine the postponement of emergency department visits during the pandemic and explore the reasons for these delays. Method: A cross-sectional study was performed in the ED of a university hospital in the Black Sea region of Turkey. The study population consisted of patients aged 18 and over. Patients meeting the inclusion criteria were given a questionnaire developed that included a COVID-19 Phobia Scale. The data collection forms were administered by ED physicians via face-to-face interviews. Results: The research was completed with 352 patients. 27.0% of the participants stated delays in their emergency department visits due to COVID-19 pandemic. The most common reasons for postponing emergency department visits were reluctance to visit a hospital because of the pandemic (46.3%), lack of an individual to accompany the patient (28.4%), and difficulty in finding proper transportation (18.9%). ED visit delays were significantly higher among single patients than married ones and were significantly lower in patients aged 31-55 compared to other patients (p0.05). Conclusion: Approximately one in three patients delayed their ED visits due to the COVID-19 pandemic. In addition to ‘fear of exposure to the disease’ which can be interpretated as a direct effect of the pandemic on postponement of emergency department visits, it also has indirect effects such as concerns over finding transportation and an individual to accompany the patient.

Aim: During the coronavirus disease-2019 (COVID-19) pandemic, the strict limitations imposed on access to many healthcare institutions may effect emergency department (ED) attendances with regards to appropriateness. Thus, this study aimed to investigate the urgency level of ED attendances and the frequency of inappropriate use (IU) during the COVID-19 pandemic. Methods:A prospective cross-sectional study was conducted in the university hospital ED during one week (May 11-17, 2020) of the post-peak period of the first wave of the COVID-19 pandemic. All adult (≥18 years) ED attendances were evaluated by emergency residents in terms of clinical and demographic characteristics and appropriateness. The data were recorded on data collection forms.Results: IU rate detected was 45.1%. In the study, 3.9% and 9.5% of attendances were in Emergency Severity Index categories 1 and 2, respectively. A significant negative correlation was found between age and IU (odds ratio=0.978; 95% confidence interval: 0.96-0.99). According to the binary logistic regression analysis, it is most likely that IUs are young people who are employed and have no chronic disease. Conclusion:This study showed that the frequency of IU decreased while the urgency level of the ED attendances increased in the post-peak period of the pandemic compared to a previous study conducted outside of the pandemic, in the same center. There was an inverse relationship between IU frequency and age. The results will help with planning ED services in future pandemic periods.