Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic
Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic
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DOI：
10.1001/jamapsychiatry.2020.4402
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发表时间：
2021-02-03
期刊：
影响因子：
25.8
通讯作者：
Houry, Debra
中科院分区：
文献类型：
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作者：
Holland, Kristin M.;Jones, Christopher;Houry, Debra
2019年冠状病毒病（COVID-19）大流行、相关缓解措施以及社会和经济影响可能会影响心理健康、自杀行为、药物使用和暴力。目的研究COVID-19大流行期间美国急诊室（ED）精神健康状况（MHCs）、自杀企图（SAs）、药物过量（OD）和暴力结果的变化。设计、环境和参与者本横断面研究使用了疾病控制和预防中心的国家综合征监测项目的数据，以检查2018年12月30日至2020年10月10日（COVID-19大流行之前和期间）MHCs、sa、ODs和暴力的全国ED就诊变化。国家综合征监测计划从覆盖48个州和华盛顿特区的3500多个急诊科中获取了大约70%的美国急诊科就诊情况。主要结果和测量结果包括mhc、sa、所有药物滥用、阿片类药物滥用、亲密伴侣暴力（IPV）和疑似虐待和忽视儿童（SCAN） ED就诊计数和率。每周急诊科就诊次数和比率按性别进行总体和分层计算。结果2018年12月30日至2020年10月10日，共收集急诊患者187 508 065例（女性53.6%，男性46.1%）；6 018 318纳入至少1项研究结果（访问不相互排斥）。自2020年3月16日起，美国实施新冠肺炎缓解措施后，急诊科总访问量有所下降。2020年3月8日至28日期间，6个结局的每周ED就诊次数均有所减少（3月8日MHCs = 42 903, SAs = 5212，所有ODs = 14 543，阿片ODs = 4752, IPV = 444, SCAN = 1090； 3月28日MHCs = 17 574, SAs = 4241，所有ODs = 12 399，阿片ODs = 4306, IPV = 347, SCAN = 487）。相反，从2020年3月22日到28日的那一周开始，急诊科的访问量有所增加。与2019年同期相比，2020年3月15日至10月10日的ED就诊次数中位数，sa （n = 4940 vs 4656, P = 0.02）和od （n = 15 604 vs 13 371, P = 0.02）明显高于2019年同期
IMPORTANCE The coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence.OBJECTIVE To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), and violence outcomes during the COVID-19 pandemic.DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program to examine national changes in ED visits for MHCs, SAs, ODs, and violence from December 30, 2018, to October 10, 2020 (before and during the COVID-19 pandemic). The National Syndromic Surveillance Program captures approximately 70% of US ED visits from more than 3500 EDs that cover 48 states and Washington, DC.MAIN OUTCOMES AND MEASURES Outcome measureswere MHCs, SAs, all drug ODs, opioid ODs, intimate partner violence (IPV), and suspected child abuse and neglect (SCAN) ED visit counts and rates. Weekly ED visit counts and rates were computed overall and stratified by sex.RESULTS From December 30, 2018, to October 10, 2020, a total of 187 508 065 total ED visits (53.6% female and 46.1% male) were captured; 6 018 318 included at least 1 study outcome (visits not mutually exclusive). Total ED visit volume decreased after COVID-19 mitigation measures were implemented in the US beginning on March 16, 2020. Weekly ED visit counts for all 6 outcomes decreased between March 8 and 28, 2020 (March 8: MHCs = 42 903, SAs = 5212, all ODs = 14 543, opioid ODs = 4752, IPV = 444, and SCAN = 1090; March 28: MHCs = 17 574, SAs = 4241, all ODs = 12 399, opioid ODs = 4306, IPV = 347, and SCAN = 487). Conversely, ED visit rates increased beginning the week of March 22 to 28, 2020. When the median ED visit counts between March 15 and October 10, 2020, were compared with the same period in 2019, the 2020 counts were significantly higher for SAs (n = 4940 vs 4656, P =.02), all ODs (n = 15 604 vs 13 371, P