Impact of the COVID-19 pandemic on medical-seeking behavior in older adults by comparing the presenting complaints of the emergency department visits

• Published in: BMC emergency medicine Vol. 23; no. 1; p. 63
• Main Authors: Chih-Hung Tai, Henry, Kao, Yi-Hao, Lai, Yen-Wen, Chen, Jiann-Hwa, Chen, Wei-Lung, Chung, Jui-Yuan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.06.2023; BioMed Central; BMC
• Subjects: Adults; Aged patients; Analysis; Behavior; Bioethics; Catastrophic events; Chief complaints; Coronavirus disease 2019; Coronaviruses; COVID-19; Emergency department; Emergency medical care; Emergency medical services; Emergency service; Health aspects; Hospitals; Human behavior; Impact analysis; Mortality; Older people; Pandemics; Patients; Psychological effects; Public health; Review boards; Severe acute respiratory syndrome coronavirus 2; Social aspects; Social behavior; Social conditions; Social factors; Taiwan; Coronavirus disease 2019; Emergency department; Chief complaints
• ISSN: 1471-227X; 1471-227X
• DOI: 10.1186/s12873-023-00819-5

The outbreak of the coronavirus disease 2019 (COVID-19) has caused a catastrophic event worldwide. Since then, people's way of living has changed in terms of personal behavior, social interaction, and medical-seeking behavior, including change of the emergency department (ED) visiting patterns. The objective of this study was to analyze the impact of the COVID-19 pandemic on the ED visiting patterns of the older people to explore its variable expression with the intention of ameliorating an effective and suitable response to public health emergencies. This was a retrospective study conducted in three hospitals of the Cathay Health System in Taiwan. Patients aged ≥ 65 years who presented to the ED between January 21, 2020, and April 30, 2020 (pandemic stage), and between January 21, 2019, and April 30, 2019 (pre-pandemic stage) were enrolled in the study. Basic demographics, including visit characteristics, disposition, and chief complaints of the patients visiting the ED between these two periods of time, were compared and analyzed. A total of 16,655 older people were included in this study. A 20.91% reduction in ED older adult patient visits was noted during the pandemic period. During the pandemic, there was a decrease in ambulance use among elderly patients visiting the ED, with the proportion decreasing from 16.90 to 16.58%. Chief complaints of fever, upper respiratory infections, psychological and social problems increased, with incidence risk ratios (IRRs) of 1.12, 1.23, 1.25, and 5.2, respectively. Meanwhile, the incidence of both non-life-threatening and life-threatening complaints decreased, with IRRs of 0.72 and 0.83, respectively. Health education regarding life-threatening symptom signs among older adult patients and avocation of the proper timing to seek medical attention via ambulance were crucial issues during the pandemic.