TY - JOUR T1 - Nationwide study on trends in unplanned hospital attendance and deaths during the 7 weeks after the onset of the COVID-19 pandemic in Denmark JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 986 LP - 995 DO - 10.1136/bmjqs-2020-012144 VL - 30 IS - 12 AU - Søren Bie Bogh AU - Marianne Fløjstrup AU - Søren Kabell Nissen AU - Stine Hanson AU - Mickael Bech AU - Søren Paaske Johnsen AU - Mette Rahbek Kristensen AU - Line Emilie Laugesen AU - Jens Søndergaard AU - Lars Folkestad AU - Erika Frischknecht Christensen AU - Daniel Pilsgaard Henriksen AU - Renee Y Hsia AU - Colin A Graham AU - Tim Alex Lindskou AU - Keld-Erik Byg AU - Morten Breinholt Søvsø AU - Henrik Laugesen AU - Peter Hallas AU - Søren Mikkelsen AU - Kim Rose Olsen AU - Lau Caspar Thygesen AU - Hejdi Gamst-Jensen AU - Mikkel Brabrand Y1 - 2021/12/01 UR - http://qualitysafety.bmj.com/content/30/12/986.abstract N2 - Background The impact of a pandemic on unplanned hospital attendance has not been extensively examined. The aim of this study is to report the nationwide consequences of the COVID-19 pandemic on unplanned hospital attendances in Denmark for 7 weeks after a ‘shelter at home’ order was issued.Methods We merged data from national registries (Civil Registration System and Patient Registry) to conduct a study of unplanned (excluding outpatient visits and elective surgery) hospital-based healthcare and mortality of all Danes. Using data for 7 weeks after the ‘shelter at home’ order, the incidence rate of unplanned hospital attendances per week in 2020 was compared with corresponding weeks in 2017–2019. The main outcome was hospital attendances per week as incidence rate ratios. Secondary outcomes were general population mortality and risk of death in-hospital, reported as weekly mortality rate ratios (MRRs).Results From 2 438 286 attendances in the study period, overall unplanned attendances decreased by up to 21%; attendances excluding COVID-19 were reduced by 31%; non-psychiatric by 31% and psychiatric by 30%. Out of the five most common diagnoses expected to remain stable, only schizophrenia and myocardial infarction remained stable, while chronic obstructive pulmonary disease exacerbation, hip fracture and urinary tract infection fell significantly. The nationwide general population MRR rose in six of the recorded weeks, while MRR excluding patients who were COVID-19 positive only increased in two.Conclusion The COVID-19 pandemic and a governmental national ‘shelter at home’ order was associated with a marked reduction in unplanned hospital attendances with an increase in MRR for the general population in two of 7 weeks, despite exclusion of patients with COVID-19. The findings should be taken into consideration when planning for public information campaigns.Data may be obtained from a third party and are not publicly available. According to Danish law, data cannot be shared. However, the data sources are available for other researchers pending approval from the Danish Health Data Authority. ER -