Equity in Emergency Department Utilization in Alberta for Priority Populations during the COVID-19 Pandemic: Exploring Impacts of Changes to Healthcare and Healthcare Utilization through Administrative Data Analysis and Nominal Group Techniques

Alberta has seen a marked decrease in emergency department presentations while pandemic control measures have been in place. In addition to public health measures including physical distancing, many patients who perceive hospitals as high-risk environments and may avoid emergency department visits, even when seriously ill. This can lead to health issues becoming worse and harder to manage. Harms associated with decreased emergency department use may be greater for some populations, who rely more heavily on emergency departments for their care. Frequent users of emergency departments are more likely to be low income and to be older. In Alberta and British Columbia, First Nations individuals utilize emergency departments at a much higher rate than non-First Nations individuals. This study builds on an existing emergency medicine research partnership with the Alberta First Nations Information Governance Centre, as well as connections to operational (Alberta Health Services) and research leaders in the areas of emergency medicine, seniors care and population health. Through information collected by the Alberta health system, we will compare emergency department use during the initial months of the pandemic to information collected last year. Among other outcomes, we will consider how numbers of ED visits, hospital admissions, deaths in ED and other serious conditions have changed during the pandemic. We will then determine if changes have been greater for First Nations, socially and materially deprived, remote and older populations than for the general population. Through structured engagement with patients, clinicians and health systems leaders, we will share findings and develop understandings of results. Highlighting harms and inequities arising from pandemic-driven changes in care patterns and systems will allow policy- and decision-makers to reduce the negative consequences of efforts to manage COVID-19.