Yang Zhang,1,* Chenggen Xiao,2,* Guoqing Huang,2 Minxue Shen1,3 

1Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha City, Hunan Province, People’s Republic of China; 2Department of Emergency, Xiangya Hospital, Central South University, Changsha City, Hunan Province, People’s Republic of China; 3Furong Laboratory, Central South University, Changsha City, Hunan Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Guoqing Huang; Minxue Shen, Email hgq97@126.com; shenmx1988@csu.edu.cn

Objective: This study aims to evaluate the impact of COVID-19 prevention and control policies on the frequency of emergency department (ED) visits in a large tertiary hospital in central China, from January 2018 to September 2023.
Methods: We conducted a multi-stage interrupted time series analysis to investigate the impact of various epidemic control policies on weekly ED visits at a tertiary hospital in Hunan Province, China. The study period ranged from January 1, 2018, to September 30, 2023, and was divided into four distinct periods: pre-epidemic, pandemic, normalized control, and end of control. Using a quasi-Poisson regression model, we examined the specific effects of these policies on emergency visits, with a particular focus on stratifying patients based on respiratory versus non-respiratory diseases.
Results: Compared to the pre-pandemic period, the number of ED visits in a tertiary hospital decreased by 38.5% (95% CI: 25.1% to 49.8%) during the COVID-19 pandemic, of which the number of ED visits for respiratory diseases increased by 79.4% (95% CI: 13.2% to 177.2%) and the number of ED visits for non-respiratory diseases decreased by 45.9% (95% CI: − 55.7% to − 34.2%). After the end of the epidemic control, the total number of ED visits increased by 31.5% (95% CI: 19.1% to 45.0%), with the number of ED visits for respiratory diseases rising by 379.2% (95% CI: 275.9% to 511.8%), but with no significant change in the number of ED visits for non-respiratory emergencies.
Conclusion: Control policies were associated with people avoiding emergency care for non-respiratory related reasons during the pandemic, while the end of control policies was associated with a sharp rise in emergency care for respiratory diseases. This study provides a scientific basis for the different changes in ED visits under the implementation of varying epidemic prevention and control policies.

Keywords: COVID-19, health policy, emergency visit, respiratory disease, interrupted time series analysis