Impacts of Major Changes in China’s COVID-19 Prevention and Control Policies on Emergency Department Visits: A Quasi-Experiment

IF 2.7 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES Risk Management and Healthcare Policy Pub Date : 2024-07-03 DOI:10.2147/rmhp.s463062

Yang Zhang, Chenggen Xiao, Guoqing Huang, Minxue Shen

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Abstract

Objective: This study aims to evaluate the impact of COVID-19 prevention and control policies on the frequency of emergency department (ED) visits in a large tertiary hospital in central China, from January 2018 to September 2023.
Methods: We conducted a multi-stage interrupted time series analysis to investigate the impact of various epidemic control policies on weekly ED visits at a tertiary hospital in Hunan Province, China. The study period ranged from January 1, 2018, to September 30, 2023, and was divided into four distinct periods: pre-epidemic, pandemic, normalized control, and end of control. Using a quasi-Poisson regression model, we examined the specific effects of these policies on emergency visits, with a particular focus on stratifying patients based on respiratory versus non-respiratory diseases.
Results: Compared to the pre-pandemic period, the number of ED visits in a tertiary hospital decreased by 38.5% (95% CI: 25.1% to 49.8%) during the COVID-19 pandemic, of which the number of ED visits for respiratory diseases increased by 79.4% (95% CI: 13.2% to 177.2%) and the number of ED visits for non-respiratory diseases decreased by 45.9% (95% CI: − 55.7% to − 34.2%). After the end of the epidemic control, the total number of ED visits increased by 31.5% (95% CI: 19.1% to 45.0%), with the number of ED visits for respiratory diseases rising by 379.2% (95% CI: 275.9% to 511.8%), but with no significant change in the number of ED visits for non-respiratory emergencies.
Conclusion: Control policies were associated with people avoiding emergency care for non-respiratory related reasons during the pandemic, while the end of control policies was associated with a sharp rise in emergency care for respiratory diseases. This study provides a scientific basis for the different changes in ED visits under the implementation of varying epidemic prevention and control policies.

Keywords: COVID-19, health policy, emergency visit, respiratory disease, interrupted time series analysis

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中国 COVID-19 防控政策的重大变化对急诊就诊率的影响：准实验

研究目的本研究旨在评估 2018 年 1 月至 2023 年 9 月期间，COVID-19 防控政策对中国中部某大型三甲医院急诊科（ED）就诊频率的影响：我们采用多阶段间断时间序列分析法，研究了各种疫情防控政策对中国湖南省某三级甲等医院每周急诊就诊人次的影响。研究期间为 2018 年 1 月 1 日至 2023 年 9 月 30 日，分为四个不同时期：疫情前、大流行、常态化控制和控制结束。利用准泊松回归模型，我们研究了这些政策对急诊就诊的具体影响，尤其侧重于根据呼吸道疾病与非呼吸道疾病对患者进行分层：与疫情发生前相比，在 COVID-19 大流行期间，三级医院的急诊就诊人数减少了 38.5%（95% CI：25.1% 至 49.8%），其中呼吸道疾病的急诊就诊人数增加了 79.4%（95% CI：13.2% 至 177.2%），非呼吸道疾病的急诊就诊人数减少了 45.9%（95% CI：- 55.7% 至 -34.2%）。疫情控制结束后，急诊室就诊总人数增加了31.5%（95% CI：19.1%至45.0%），其中呼吸道疾病急诊室就诊人数增加了379.2%（95% CI：275.9%至511.8%），但非呼吸道急诊室就诊人数没有显著变化：结论：在大流行期间，控制政策与人们避免因非呼吸道相关原因接受急诊治疗有关，而控制政策的结束与呼吸道疾病急诊就诊人数的急剧上升有关。这项研究为不同的疫情防控政策实施过程中急诊就诊率的不同变化提供了科学依据：COVID-19、卫生政策、急诊就诊、呼吸道疾病、间断时间序列分析

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来源期刊

Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.20

自引率

2.90%

发文量

242

审稿时长

16 weeks

期刊介绍： Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.