COVID-19 related reduction in pediatric emergency healthcare utilization - a concerning trend.


Journal

BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804

Informations de publication

Date de publication:
07 09 2020
Historique:
received: 17 05 2020
accepted: 19 08 2020
entrez: 7 9 2020
pubmed: 8 9 2020
medline: 18 9 2020
Statut: epublish

Résumé

The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization. We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019. In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred. Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.

Sections du résumé

BACKGROUND
The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization.
METHODS
We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019.
RESULTS
In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred.
CONCLUSIONS
Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.

Identifiants

pubmed: 32894080
doi: 10.1186/s12887-020-02303-6
pii: 10.1186/s12887-020-02303-6
pmc: PMC7475725
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

427

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Auteurs

Christian Dopfer (C)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany.

Martin Wetzke (M)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany.
German Center for Lung Research, Biomedical Research in End Stage and Obstructive Lung Disease, BREATH Hannover, Hanover, Germany.
German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Braunschweig, Germany.

Anna Zychlinsky Scharff (A)

Department of Pediatrics, Hannover Medical School, Hannover, Germany.

Frank Mueller (F)

Department of General Practice, University Medical Centre Goettingen, Goettingen, Germany.

Frank Dressler (F)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany.

Ulrich Baumann (U)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany.

Michael Sasse (M)

Department of Pediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany.
Pediatric Intensive Care Network Northern Germany/ PIN, Hannover Medical School, Hannover, Germany.

Gesine Hansen (G)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany.
German Center for Lung Research, Biomedical Research in End Stage and Obstructive Lung Disease, BREATH Hannover, Hanover, Germany.
Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.

Alexandra Jablonka (A)

German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Braunschweig, Germany.
Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.

Christine Happle (C)

Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Carl-Neuberg-Straße 1, D - 30625, Hannover, Germany. happle.christine@mh-hannover.de.
German Center for Lung Research, Biomedical Research in End Stage and Obstructive Lung Disease, BREATH Hannover, Hanover, Germany. happle.christine@mh-hannover.de.

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