Impact of COVID-19 on emergency department visits for individuals with psychotic disorders in Newfoundland and Labrador, Canada: A longitudinal study
Bibliographic record
Abstract
During the global COVID-19 pandemic, emergency departments (EDs) saw an overall decrease in utilization. However, some vulnerable groups, such as those living with psychotic disorders, must often rely on the services provided by EDs. The literature in this area lacks methodologically robust longitudinal studies which examine the ED utilization patterns of individuals with psychotic disorders both before and during the pandemic. This research was a longitudinal retrospective cohort study of individuals with a psychotic disorder in Newfoundland and Labrador before COVID-19 (2011-2019) and during the pandemic (2020-2022). Patients diagnosed with a psychotic disorder between April 1st, 2011, and March 31st, 2022, who were between 15-24 years old, and who visited an ED at least once, were included. Average monthly visits were used to measure ED visits to control for differences in each individual's data. Independent variables in the analyses were: 1) age, 2) sex, 3) geographic region, 4) urban or rural residence, and 5) ED visit before or during COVID-19. Multiple linear regression with Generalized Estimating Equations (GEE) modelling was used to identify factors associated with mean monthly ED visits. Multivariate analysis showed the mean monthly ED visits increased significantly during the first year of COVID-19 than before the pandemic (Mean = 0.30 vs Mean = 0.21, p = 0.01). Female individuals and rural residents also had significantly higher mean monthly ED visits than male individuals (Female = 0.51 vs Male = 0.21, p < 0.01) and urban residents (rural = 0.38 vs urban = 0.21, p = 0.02). ED utilization by individuals with psychotic disorders increased during the first year of the COVID-19 pandemic, while ED use by most Canadians decreased. This study identified the demographics of Canadians who require extra support during a health crisis. There is always the possibility of another global pandemic, and the Canadian healthcare system must be equipped to provide adequate services to all Canadians, especially those who are most marginalized.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".