Impact of COVID-19 pandemic on health system activity
The Bureau of Health information (BHI) has today released its latest Healthcare Quarterly report, showing activity and performance for public hospital and ambulance services in NSW during April to June 2020.
BHI has also published a COVID-19 supplement to this issue of Healthcare Quarterly, which focuses on activity at NSW level from January to June 2020, providing greater insights into the impact of the COVID-19 pandemic on the health system.
BHI Chief Executive Dr Diane Watson said the report reveals the impact of the pandemic, particularly the far-reaching changes to people’s lives, and the preparedness and response by the NSW health system, on activity in public hospitals and for NSW Ambulance.
“There was a drop of more than 18% in emergency department (ED) attendances during the April to June quarter compared with the same quarter last year,” Dr Watson said.
There were 615,690 ED attendances in the April to June 2020 quarter, down 138,778 (18.4%). The most striking decreases were in the urgent (triage 3) and semi-urgent (triage 4) categories, down 21.9% and 29.2%, respectively.
“Having peaked in mid-March, weekly ED attendances fell sharply by more than 40% to mid-April 2020, before starting to steadily increase again. By the last week of June, attendances were down 9% compared with the same week in 2019,” Dr Watson said.
The exception to the decline in ED attendances were non-urgent (triage 5) presentations, which were up by 21,314 (31.5%) in the April to June quarter, compared with the same quarter last year.
“Although most COVID-19 testing moved to separate dedicated testing clinics from late March, the increase in triage 5 presentations over this period is primarily due to COVID-19 testing that occurred within EDs or co-located testing clinics,” Dr Watson said.
The timeliness of care delivered in EDs improved. The percentage of ED patients in NSW treated on time in April to June 2020 was up 12.4 percentage points to 84.2% and the percentage of patients who left the ED within four hours of arrival was up 4.7 percentage points to 75.3%.
From 26 March 2020, the National Cabinet suspended all non-urgent elective surgery, with all urgent and some exceptional semi-urgent surgery continuing, before a staged resumption of surgical activity from late April.
The number of elective surgical procedures performed in NSW during April to June 2020 was 35,807, down 23,305 (39.4%) compared with the same quarter the previous year. This drop was concentrated in the semi-urgent and non-urgent categories, down 27.3% and 67.1% respectively. The number of urgent surgeries performed was similar to the same quarter last year, down just 213 (1.7%).
The number of people on the waiting list on 30 June 2020 was up 16,895 (20.1%) to 101,026. Of those patients, 10,563 had waited longer than the clinically recommended time for their surgery. The vast majority of these patients were in the semi-urgent (2,179) and non-urgent (8,379) categories.
“In the last week of June, 4,062 procedures were performed, down 16% compared with 2019. Looking at each category for that last week of June, the number of urgent procedures was the same as in 2019, the number of semi-urgent procedures was down 10%, and the number of non-urgent procedures was down 29.7%.”
The percentage of procedures performed within clinically recommended time frames during April to June 2020 was down 11.7 percentage points to 84.7%, though almost all urgent procedures (99.6%) were performed on time.
There were 270,564 ambulance responses, where a vehicle was dispatched, in April to June 2020, down 39,264 (12.7%) compared with the same quarter last year.
The number of responses to life-threatening cases was relatively stable at 6,469, down just 82 (1.3%).
The median ambulance response time for life-threatening (priority 1A) cases also remained relatively stable at 7.8 minutes (up 0.3 minutes).
The number of responses to emergency cases overall (priority 1) was down 12.0% to 123,071. NSW Ambulance paramedics reached around six in 10 (61.3%) emergency cases within 15 minutes, up 2.2 percentage points.
“The number of ambulance responses declined in late March and early April. There was then a steady increase to the end of June, though responses in the last week of June were still down more than 10% compared with the same week in 2019,” Dr Watson said.
“The number of life-threatening cases requiring an ambulance response remained at similar levels throughout the first six months of 2020 when compared with the same period in 2019.”
The number of admitted patient episodes in NSW public hospitals in April to June 2020 was 406,221, down 80,193 (16.5%) compared with the same quarter last year, with the number of acute overnight patient episodes down 47,275 (19.4%).
Healthcare Quarterly, April to June 2020 contains detailed activity and performance information for EDs, elective surgery, NSW Ambulance, admitted patients and seclusion and restraint, including – for the first time – trends over time for seclusion and restraint in NSW.