Effect of the COVID-19 Pandemic on Patients with Chronic Disease Emergency Department Visits

Aim: This study aims to evaluate how the COVID-19 pandemic affected emergency department utilization among patients with chronic diseases, with a particular focus on changes in visit frequency, timing, mode of arrival, and patient behaviors. Methods: This cross-sectional, descriptive, and analytical study included 372 adult patients surveyed face- to-face in the emergency department of a tertiary hospital between December 1, 2022, and February 1, 2023. The 14-item questionnaire assessed sociodemographic characteristics and patterns of emergency department use before and during the pandemic. Comparisons were made using the McNemar and McNemar–Bowker tests. Results: Emergency department visit frequency significantly declined during the pandemic, while the proportion of visits leading to hospital admission increased. Night-time presentations and ambulance arrivals also rose markedly. Most participants reported fear of visiting the emergency department, primarily due to concerns about COVID-19 transmission. Patients with cardiovascular and renal disease demonstrated a significant reduction in emergency department use, whereas no meaningful change was observed among oncology or pulmonary patients. Conclusion: The COVID-19 pandemic led to a dual impact on emergency care utilization-reducing unnecessary visits but delaying urgent care for individuals with chronic diseases. Strengthening public communication and ensuring safe access to emergency services are essential priorities for future health crises. Keywords: COVID-19, emergency services utilization, chronic disease, health-seeking behavior, patients, attitudes