RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP 986
OP 995
DO 10.1136/bmjqs-2020-012144
VO 30
IS 12
A1 Søren Bie Bogh
A1 Marianne Fløjstrup
A1 Søren Kabell Nissen
A1 Stine Hanson
A1 Mickael Bech
A1 Søren Paaske Johnsen
A1 Mette Rahbek Kristensen
A1 Line Emilie Laugesen
A1 Jens Søndergaard
A1 Lars Folkestad
A1 Erika Frischknecht Christensen
A1 Daniel Pilsgaard Henriksen
A1 Renee Y Hsia
A1 Colin A Graham
A1 Tim Alex Lindskou
A1 Keld-Erik Byg
A1 Morten Breinholt Søvsø
A1 Henrik Laugesen
A1 Peter Hallas
A1 Søren Mikkelsen
A1 Kim Rose Olsen
A1 Lau Caspar Thygesen
A1 Hejdi Gamst-Jensen
A1 Mikkel Brabrand
YR 2021
UL http://qualitysafety.bmj.com/content/30/12/986.abstract
AB 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.