J Korean Soc Emerg Med.  2022 Dec;33(6):616-630.

Identifying the perception of difficulty in emergency department utilization recognized by Daegu citizens during the COVID-19 pandemic and its contributing factors

Affiliations
  • 1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
  • 2Department of Emergency Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
  • 3Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Daegu, Korea
  • 4Public Health and Medicine Office, Kyungpook National University Hospital, Daegu, Korea

Abstract


Objective
The purpose of this study was to identify if there was a perception of difficulty in using emergency department (ED) services during the coronavirus disease 2019 (COVID-19) pandemic and the contributing factors to this situation through a cross-sectional public survey in a metropolitan city.
Methods
In November 2020, face-to-face interviews based on a structured questionnaire were conducted with 1,000 citizens. A multivariable logistic regression analysis was performed to identify the factors affecting the perception of difficulty in using the ED.
Results
Of the respondents, 65.2% (58.9% male and 71.3% female) perceived difficulty in using ED services during the pandemic. By age, 69.8% of those who had this perception were under the age of 40 years ; 63.2% were 40-64 years old, and 61.1% were over the age of 65. Of the total number of respondents, 24.8% and 13.8% said they would hesitate to visit ED for chest pain and neurological symptoms, respectively. As a result of multivariate analysis, the significant contributing factors were age under 40 years old, female gender, fear of in-hospital COVID-19 contagion, emergency medical technician (EMT) referral to the ED, and prior experience with the emergency medical service (EMS) dispatch center.
Conclusion
A significant percentage of respondents perceived that it was difficult to use ED services during the COVID19 pandemic, even when experiencing chest pain and neurological symptoms, which require urgent treatment. Younger age, women, and fear of nosocomial COVID-19 contagion appear to have aggravated this situation. Conversely, prior experience with the EMS dispatch center and visits to the EMT-recommended ED facilitated ED utilization.

Keyword

COVID-19; Emergency department; Utilization
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