How did the COVID-19 Pandemic Affect Inappropriate Adult Emergency Department Attendances?: A Prospective Cross-Sectional Study

Abstract

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.