The long-run effect of COVID-19 on hospital emergency department attendances:evidence from statistical analysis of hospital data from England

• Emergency department attendances fell around the world during COVID-19. • We analyse national data on subgroups of Accident and Emergency attendances. • Attendances differentiated by acuity, age and diagnosis groups showed similar declines. • Lockdowns, public messaging, and changes in health care provision are possible causes. • These policies may have led to unmet need in emergency care. During the COVID-19 pandemic, hospital emergency departments worldwide experienced a pronounced fall in utilisation of emergency care, with a decrease of up to 40% in many countries. Evidence suggests the cause of these changes include both population fear of COVID-19 and the effects of lockdowns and the interaction of these two effects. We analyse a sub-sample of national data on Accident and Emergency (A&E) attendances in England over an extended period from April 2019 to March 2022 for different patient groups, including by age, mental/physical health status, acuity, and common clinical groupings. Our results showed that all patient groups experienced substantial declines in attendances during the first two waves of the pandemic, including high acuity and cardiovascular patients. Mental health patients were the only exception, with a smaller decline in attendances. Our findings suggest that policymakers should recognise the potential harmful effects of lockdowns, public messaging, and changes in health care provision on all patients during health emergencies.