Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study

Abstract

In 2020, Taiwan’s healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent ED users remains unknown. This cohort study determined the impact of the COVID-19 pandemic on healthcare-seeking behaviors among frequent ED users at Taipei City Hospital, Taiwan. We included ED users aged ≥18 years admitted to Taipei City Hospital during February 2019–January 2020 (before the pandemic) and February 2020–January 2021 (during the pandemic). Frequent ED users were patients with four or more ED visits per year. Stepwise logistic regression was performed to identify predictors of frequent ED use during the COVID-19 pandemic. Frequent ED users had shorter hospital stays in the ED during the pandemic. After adjusting for sociodemographic factors and other covariates, patients with a triage status of level 4–5, pneumonia diagnosis, giddiness, or dyspnea were more likely frequent ED visitors during the COVID-19 pandemic. To reduce the risk of acquiring COVID-19, it is important to utilize territorial healthcare or telehealth to avoid inappropriate ED visits for patients with a low level of risk or chronic disease.

Preferences for Attributes of Initial COVID-19 Diagnosis in the United States and China During the Pandemic: Discrete Choice Experiment With Propensity Score Matching

“…During COVID-19, a run on the medical resources was well noted in the world, and the failure to implement nucleic acid testing in the early stage led to widespread SARS-CoV-2 in the community and the late imposing of identification-tracing-isolation of those infected [ 22 , 23 ]. With medical resources directed to compensate for these newly emerging infectious diseases and health care facilities crowded with infectious patients, studies have identified the difficulties and burdens patients with diseases other than COVID-19 faced during the pandemic [ 24 , 25 ]. Nevertheless, the health-seeking behavior of those potentially infected with COVID-19 during the pandemic was not explored.…”

Modelling Granular Process Flow Information to Reduce Bottlenecks in the Emergency Department

“…The data were collected pre-pandemic, the onset of which required the introduction of hot and cold areas in the ED. Similar to other EDs, there was a reduction in attendance at the beginning of the pandemic [125,126]; however, the problems that existed pre-pandemic are still prevalent, resulting in poor performance of waiting time targets [125], hence making the focus of this paper current.…”

Examining patient flow in a tertiary hospital’s emergency department at a low coronavirus prevalence region

“…In February 2020, most parameters used to measure the input of patient flow in our ED dropped sharply and reached their lowest point in April. Other tertiary hospitals and the largest healthcare organization in northern Taiwan found that ED visits decreased, similarly, from February to April 2020 [29,33,37].…”