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The impact of COVID-19 on public and private emergency departments in Queensland, Australia.

Amy Sweeny, Emma Hall, Anthony Padowitz, Ben Walters, Ping Zhang, Kylie Alcorn, Gerben Keijzers, Andrea Marshall, Jamie Ranse, Julia Crilly

Abstract

Objective: COVID-19 affected healthcare globally. The aim of this study was to investigate the impact of COVID-19 on both public and private emergency departments (EDs). Methods: This was a retrospective cohort study of ED presentations made to three private and two public hospital EDs located in one region in Queensland. Presentation rates per 1,000 population and incident rate ratios (IRR) for three time periods: T1: pre-pandemic (Mar-Jun 2018/2019), T2: initial restrictions (Mar-Jun 2020), and T3: restrictions easing (Mar-Jun 2021) were calculated. Linear trends were produced to describe pre- and post-pandemic changes. Additional outcomes reported for public EDs included ED length of stay (LoS) and cost. Results: In T2, both public and private ED presentation rates decreased by 12% (overall IRR 0.88; 95% confidence interval (CI: 0.87-0.89)). Private EDs experienced a quicker and greater return of patient volumes in T3, exceeding T1 levels. Median ED LoS decreased and then increased above pre-pandemic levels (T1: 159 minutes; T2: 151 minutes; T3:201 minutes). Total costs were higher during T2 but then decreased during T3, below that of T1 (T1: $652; T2: $791; T3: $566). Between Feb 2020-Jun 2021, 269 people tested positive for SARS-CoV-2; 19 of whom (7.1%) interfaced with the ED. Conclusions: During initial COVID19 restrictions, a shift towards fewer ED presentations was observed. Private ED presentations rebounded more quickly than public. Few COVID-19 patients interfaced with ED. Systems and public-private agreements made during this time appeared to protect EDs and soften the impact of reduced volumes for the private sector.

AH24182  Accepted 18 December 2024

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