{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:05:10Z","timestamp":1791360310318,"version":"4.3.1"},"reference-count":10,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T00:00:00Z","timestamp":1597190400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1935789320003031_as1\"><jats:title>Objective:<\/jats:title><jats:p>Since the beginning of the coronavirus disease (COVID-19) pandemic, several frontline workers have expressed their concerns about reduced emergency department (ED) utilization. We aimed to examine the changes in ED utilization during the early phase of the COVID-19 pandemic, in a country with a well-developed primary care system.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789320003031_as2\"><jats:title>Methods:<\/jats:title><jats:p>A retrospective analysis of ED utilization was performed in 3 Dutch hospitals during a 60-day period, starting on February 15, 2020. The identical period in 2019 was used as a reference. ED visits were labeled as <jats:italic>COVID-related<\/jats:italic> (defined as COVID-19 suspected) or <jats:italic>non-COVID-related<\/jats:italic>. Admission rates were compared using chi-square tests, and the reduction in ED visits was assessed descriptively.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789320003031_as3\"><jats:title>Results:<\/jats:title><jats:p>During the study period, daily ED volume was 18% lower compared to that of 2019. ED utilization further declined (-29%) during lockdown. Combined admission rates were higher in 2020 compared to those in 2019 (<jats:italic>P<\/jats:italic> &lt; 0.001), and they were higher for COVID-19 versus non-COVID-19 ED visits (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec id=\"S1935789320003031_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>ED utilization was markedly reduced during the local rise of COVID-19 in a region with a well-developed primary care system and relatively low ED self-referral rates. Although it cannot directly be concluded from the findings of our study, this observation likely reflects a complex interaction between pure lockdown effects and viral fear, which warrants further research.<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2020.303","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T08:07:03Z","timestamp":1597219623000},"page":"36-39","source":"Crossref","is-referenced-by-count":71,"title":["Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect?"],"prefix":"10.1017","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7185-9491","authenticated-orcid":false,"given":"Dennis G.","family":"Barten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon H.P.","family":"Latten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits H.M.","family":"van Osch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,8,12]]},"reference":[{"key":"S1935789320003031_ref6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-2026.2003.00495.x"},{"key":"S1935789320003031_ref5","article-title":"Emergency department operations in a large health system during COVID-19","author":"Cohen","year":"2020","journal-title":"Am J Emerg Med"},{"key":"S1935789320003031_ref10","article-title":"COVID-19 pandemic: impact caused by school closure and national lockdown on pediatric visits and admissions for viral and non-viral infections, a time series analysis","author":"Angoulvant","year":"2020","journal-title":"Clin Infect Dis"},{"key":"S1935789320003031_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1400-z"},{"key":"S1935789320003031_ref4","unstructured":"4. National Institute for Public Health and the Environment. Current information about COVID-19 (novel coronavirus). August 18, 2020. https:\/\/www.rivm.nl\/en\/novel-coronavirus-covid-19\/current-information. Accessed June 15, 2020."},{"key":"S1935789320003031_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2009166"},{"key":"S1935789320003031_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2020.04.046"},{"key":"S1935789320003031_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/01.EDE.0000101748.28283.97"},{"key":"S1935789320003031_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.05.016"},{"key":"S1935789320003031_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000718"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789320003031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T10:49:23Z","timestamp":1660646963000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789320003031\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,12]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["S1935789320003031"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2020.303","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"value":"1935-7893","type":"print"},{"value":"1938-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,12]]}}}