Emergency Transport Refusal during the Early Stages of the COVID-19 Pandemic in Gyeonggi Province, South Korea

Abstract

We analyzed the changes in patients' clinical characteristics and transport refusal pre- and post-COVID-19 and identified the reasons for transport refusal using emergency medical services run sheet data from pre-COVID-19 (April-December 2019) and post-COVID-19 (April-December 2020) in Gyeonggi Province, South Korea. We included patients aged >= 18 years. Univariate and multivariate logistic regression analyses were performed to identify the relationship between patients' personal factors and clinical characteristics and emergency transport refusal. During the control and study periods, 612,681 cases were reported; the transport refusal rates during the control and study periods were 6.7% and 8.2%, respectively. Emergency transport refusal was associated with younger age, the male sex, a normal mental status, a shock index < 1, and trauma in both the pre- and post-COVID-19 periods. Although fever prevented transport refusal during the pre-COVID-19 period (aOR, 0.620; 95% CI, 0.567-0.679), it became a significant risk factor for transport refusal during the post-COVID-19 period (aOR, 1.619; 95% CI, 1.534-1.709). The most common reason for transport refusal by critically ill patients was "because it was not accepted within the jurisdiction and remote transport was required." It is necessary to expand the response capacity of patients with fever in the community to reduce the refusal of transport by critically ill patients.