Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand

Objective To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand.Design A descriptive cross-sectional, observational study.Setting High-quality data from ambulance electronic clinical records, New Zealand.Participants Ambulance rec...

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Autores principales: Bridget Dicker, Andrew Swain, Verity Frances Todd, Bronwyn Tunnage, Emma McConachy, Haydn Drake, Michelle Brett, Dan Spearing, Graham John Howie
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Publicado: BMJ Publishing Group 2020
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spelling oai:doaj.org-article:f7145800db614a5ea8403a27f08077d02021-11-11T17:00:13ZChanges in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand10.1136/bmjopen-2020-0447262044-6055https://doaj.org/article/f7145800db614a5ea8403a27f08077d02020-12-01T00:00:00Zhttps://bmjopen.bmj.com/content/10/12/e044726.fullhttps://doaj.org/toc/2044-6055Objective To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand.Design A descriptive cross-sectional, observational study.Setting High-quality data from ambulance electronic clinical records, New Zealand.Participants Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020).Main outcome measures Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period.Results During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005).Conclusions Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population’s mental well-being will need to be seriously considered against the benefits of elimination of virus transmission.Bridget DickerAndrew SwainVerity Frances ToddBronwyn TunnageEmma McConachyHaydn DrakeMichelle BrettDan SpearingGraham John HowieBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 10, Iss 12 (2020)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
spellingShingle Medicine
R
Bridget Dicker
Andrew Swain
Verity Frances Todd
Bronwyn Tunnage
Emma McConachy
Haydn Drake
Michelle Brett
Dan Spearing
Graham John Howie
Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
description Objective To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand.Design A descriptive cross-sectional, observational study.Setting High-quality data from ambulance electronic clinical records, New Zealand.Participants Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020).Main outcome measures Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period.Results During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005).Conclusions Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population’s mental well-being will need to be seriously considered against the benefits of elimination of virus transmission.
format article
author Bridget Dicker
Andrew Swain
Verity Frances Todd
Bronwyn Tunnage
Emma McConachy
Haydn Drake
Michelle Brett
Dan Spearing
Graham John Howie
author_facet Bridget Dicker
Andrew Swain
Verity Frances Todd
Bronwyn Tunnage
Emma McConachy
Haydn Drake
Michelle Brett
Dan Spearing
Graham John Howie
author_sort Bridget Dicker
title Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
title_short Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
title_full Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
title_fullStr Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
title_full_unstemmed Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand
title_sort changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of covid-19: an observational study from new zealand
publisher BMJ Publishing Group
publishDate 2020
url https://doaj.org/article/f7145800db614a5ea8403a27f08077d0
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