THE NUMBER OF people attending emergency departments (EDs) in Irish hospitals fell sharply at the onset of the Covid-19 pandemic, new research has shown.

The Economic and Social Research Institute (ESRI) has analysed HSE data on ED attendance in public hospitals for the first three months of 2020.

The average number of daily ED attendances at the end of March was approximately half what it was at the beginning of March.

Between 1 January and 29 February, the number of attendances averaged between 3,200 and 3,700 per day.

The average number of daily attendances in the week ending 1 March was 3,503, compared to 1,912 in the week ending 29 March – a decrease of 45.4%.

Similar reductions were seen across each region of the country. The reductions were substantial across all age groups, with particularly high reductions amongst younger age groups.

The report notes that a number of factors may have contributed to the decline in attendances.

“In particular, the timing of the reductions suggests that the public may be concerned about attending health facilities when there is a risk of contracting Covid-19 or fear that they are adding to the pressure on the health service.

“To help ensure that members of the public receive healthcare when they need it, more may need to be done to reassure them that it is safe and proper to contact their GP or attend hospital EDs,” the report states.

Decrease in GP referrals

In the first quarter of 2019, just over half of people who attended EDs (51.9%) were classed as self-referrals, while over a third of people (36%) were referred by a GP.

In the first three months of this year, there was a slight decrease in the proportion of GP referrals, down to 33.6%, and an increase in the proportion of self-referrals, up to 55.6%.

Looking at March in particular, when Covid-19 restrictions were introduced, there was an annual reduction in the proportion of attendances referred by a GP from 35.1% to 30.2%, and an increase in self-referrals from 54.6% to 58.9%.

The ESRI report notes that this may be indicative of lower GP use in March 2020 compared to March 2019.

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In general, just over one in every four of those attending EDs are subsequently admitted to the hospital. The numbers admitted to hospital and not admitted (the majority are discharged home) both saw reductions in March 2020.

The number of patients admitted to hospitals from EDs in March was 25% lower than the number admitted in March 2019, and 16% lower than the figures in February 2020.

Admitted patients did compose a slightly larger proportion (27.9%) of ED attendances in March 2020 than earlier months.

Aoife Brick, Research Officer at the ESRI, said the figures “suggest that there are people who did not attend the ED following the onset of the Covid-19 outbreak in Ireland when under normal circumstances they would have”.

“The public must be encouraged not to ignore symptoms and attend EDs when they need to,” she added.

Earlier this month, the HSE said the fact fewer general hospital beds were available indicated that more non-Covid patients were presenting at hospitals, following concerns people who needed medical help were avoiding hospitals because of the pandemic.