Impact of Victorian COVID-19 restrictions on emergency department presentations and hospital admissions for ophthalmic conditions

ABSTRACT

Clinical Relevance

Assessing the extent to which COVID-19 impacted hospitals can provide important learnings for future pandemics.

Background

This study aims to determine the impact of the 7-month duration COVID-19 pandemic-related lockdown orders on ophthalmology-related hospital admissions and emergency department (ED) presentations, during 2020 in Victoria, Australia.

Methods

Analysis was performed on Victorian statewide data from the Victorian Emergency Minimum Dataset (VEMD) and Victorian Admitted Episodes Dataset (VAED), between 1 January 2018 and 31 October 2020. Numbers of presentations and admissions for key ophthalmic conditions were stratified by age, socioeconomic status, location (metropolitan versus rural), and triage category. From the observations occurring in the pre-pandemic period (January 2018 to March 2020), a linear regression prediction model was built for each diagnosis which predicted what the presentation number in the COVID-19 period would have been if the pandemic had not occurred.

Results

Based on pre-COVID-19 trends, the largest decreases in expected admissions were for glaucoma (32.9%) and retinal breaks and detachments (21.2%). For the ED data, the most apparent changes were: an increase in presentations for foreign bodies (22.6%); a decrease in retinal detachments (35.5%); and a decrease in keratitis (18.4%) relative to predictions.

Conclusions

Hospital admissions decreased and patterns of ED attendances changed during lockdown. The findings suggest the need for the following: increased safety messaging to avoid eye injuries around the home; improved pathways for safe and rapid triaging of eye conditions in the community to ensure effective use of ED resources; and messaging to ensure that people do not delay care when they notice signs of sight-threatening conditions such as retinal detachment.

KEYWORDS:

• COVID-19
• emergency department
• eyecare
• hospital admissions
• ophthalmology

Acknowledgment

The authors would like to acknowledge the Victorian Department of Health as the source of VAED and VEMD data for this study, and the Centre for Victorian Data Linkage (Victorian Department of Health) for the provision of data linkage.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/08164622.2022.2144713

Additional information

Funding

This project was supported by the Victorian Department of Health’s Victorian Collaborative Healthcare Recovery Initiative. The Murdoch Children’s Research Institute is supported by the Victorian Government’s Operational Infrastructure Support Program.