An Interrupted Time-Series Analysis of Pediatric Emergency Department Visits During the Coronavirus Disease 2019 Pandemic

Irvine, Michael; Portales-Casamar, Élodie; Goldman, Ran D.

doi:10.1097/pec.0000000000002404

Cited by 8 publications

(17 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reductions in communicable disease presentations have also been observed in other countries 16. This contrasts with acute surgical presentations that have been hardly affected by the pandemic 17…”

Section: Discussionmentioning

confidence: 96%

“…16 This contrasts with acute surgical presentations that have been hardly affected by the pandemic. 17 There has been a concern that the reduction in presentations might have impacted on the timely access of patients to medical care. 10 One study focusing on the initial few weeks of the pandemic in UK and Ireland found that only 6.5% of presentations to children's EDs were delayed.…”

Section: Other Studies Considering the Impact Of The Pandemic On Ed P...mentioning

confidence: 99%

See 1 more Smart Citation

Impact of COVID-19 pandemic on emergency department attendances for young people

et al. 2022

View full text Add to dashboard Cite

IntroductionThere are concerns that the COVID-19 pandemic is having an indirect negative impact on young people. We aimed to assess the impact of the pandemic on emergency department (ED) presentations and admissions.DesignWe analysed ED presentations and admissions from a 5-year period (April 2016–February 2021). An interrupted time series analysis was used to estimate the presentations and admissions that would have been seen in year 5 without the pandemic using the data from years 1 to 4. These estimations were used to calculate the difference between the expected and the observed presentations and admissions during the pandemic year.ResultsThere were 166 459 presentations over 5 years. There was a 38.1% (95% CI 33.9% to 42.3%) reduction in presentations during the pandemic with no variation by sex, age, deprivation or ethnicity. Largest reductions were associated with children being home schooled rather than with lockdowns. For admissions, there was a 23.4% (17.4% to 29.4%) reduction, less for 5–17 year age group. Infection and asthma/wheeze presentations reduced by around 60% with smaller reductions for mental health and trauma. There was no change for surgical presentations, burns/scolds or allergic reactions. There was an increase in females aged 11–17 years presenting with mental health issues during the pandemic.ConclusionsDuring the pandemic, there was a substantial reduction in both ED presentations and admissions. The differential impact on specific presentations suggests this was due to the impact of social distancing and reduced social mixing rather than widening of health inequality or increased barriers to care.Trial registration numberNCT04893122.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Other Studies Considering the Impact Of The Pandemic On Ed P...mentioning

confidence: 99%

Impact of COVID-19 pandemic on emergency department attendances for young people

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Future studies are needed compare our results to those seen during and after the COVID-19 pandemic, which resulted initially in huge decreases in PED utilization, 27 as well as patient delays in arrival to PED 28 . As travel restrictions loosen, more typical seasonal patterns of ED usage may emerge.…”

Section: Discussionmentioning

confidence: 84%

Pediatric ED Utilization in a Destination City

2022

View full text Add to dashboard Cite

Objectives: Seasonal variation in emergency department (ED) visits has been shown for a variety of pediatric conditions, but previous studies have not considered how geographic location may also influence when and why these patients present to the ED. Our study examined the demographic and clinical characteristics as well as the seasonal variation among 3 patient populations (locals, in-state nonlocals, and out-of-state visitors) presenting to our pediatric ED (PED), which is located in a coastal, destination city.Methods: This was a retrospective chart review of PED visits from June 2014 to June 2019 at the Medical University of South Carolina Children's Hospital, a tertiary care facility located in Charleston, SC. Pediatric ED encounters were divided into 3 groups, depending on the patient's home address: local patients residing in the 3 surrounding metro counties, in-state but nonlocal patients, and out-of-state patients. Demographic and clinical information was abstracted for each visit and compared among the 3 patient groups. Seasonal variation among PED visits was determined by recording the week of the year during which each visit occurred. Results:Local patients accounted for more than 90% of PED visits with increases in visits from October to April. In-state nonlocal patients presented at consistent rates throughout the year, whereas out-of-state ED utilization peaked significantly during the summer months, Spring Break, Thanksgiving, and Christmas. Our local patient population was majority African American; our in-state nonlocal patients roughly matched our state's racial demographics, and our out-of-state population was predominantly White. Compared with in-state nonlocal patients, our local patients were more likely to present with an infection-related complaint and be diagnosed with lower-acuity conditions such as viral infection, otitis media, upper respiratory infection, cough, fever, and gastroenteritis. In-state nonlocal patients had the highest average triage acuity, more frequently had laboratory tests and imaging ordered, and were more than 4.5 times as likely to be admitted to the hospital compared with our local patients. In-state nonlocal patients were also more likely to present with a psychiatric chief complaint compared with our local patients. Out-of-state patients had a similar overall acuity to local patients but were more likely to have imaging ordered and be diagnosed with injuries such as fractures. Conclusion:At our institution, local patients, in-state nonlocal patients, and out-of-state patients exhibited 3 distinct patterns of PED utilization. Knowledge of these trends can be used to optimize resource allocation and follow-up planning, particularly for our out-of-state patient population.

show abstract

“…Several studies report a steep decrease in paediatric ED visits since the COVID-19 pandemic began 4–7. A Canadian study of 11 paediatric centres reported a decrease in ED visits by 58% during the pandemic, compared with estimated rates 8.…”

Section: Introductionmentioning

confidence: 99%

“…3 Several studies report a steep decrease in paediatric ED visits since the COVID-19 pandemic began. [4][5][6][7] A Canadian study of 11 paediatric centres reported a decrease in ED visits by 58% during the pandemic, compared with estimated rates. 8 The literature highlights that reduced ED usage may be a result of increased lockdown measures, social distancing and fear of contracting SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 pandemic on emergency department visits and infant health: a scoping review protocol

et al. 2022

View full text Add to dashboard Cite

IntroductionThe novel SARS-CoV-2 pandemic has provided a set of unique challenges for paediatric patients requiring emergency care across the globe. Reduction in paediatric emergency department (ED) usage during the COVID-19 pandemic has been widely reported, but no studies to date have consolidated and described what ramifications these reductions may have on neonatal and infant health. This scoping review aims to characterise the impact of the COVID-19 pandemic on infant ED visits and neonatal and infant health.Methods and analysisA comprehensive literature search will be conducted from March 2020 to July 2022 using the following databases: Embase (Ovid), Web of Science (Clarivate Analytics), Medline (Ovid) and CINAHL (EBSCOhost). This scoping review will use a five-step framework to guide the selection, extraction and analysis of data from eligible studies, with an additional sixth step for clinical consultation. Studies in English reporting the effect of the COVID-19 pandemic on infant ED visits, as well as neonatal and infant health, will be included for screening. Key findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Ethics and disseminationResearch ethics board approval will not be required due to the nature of the study design. The results of this scoping review will be disseminated through publication in a peer-reviewed journal and presentation at academic conferences.

show abstract

An Interrupted Time-Series Analysis of Pediatric Emergency Department Visits During the Coronavirus Disease 2019 Pandemic

Cited by 8 publications

References 14 publications

Impact of COVID-19 pandemic on emergency department attendances for young people

Impact of COVID-19 pandemic on emergency department attendances for young people

Pediatric ED Utilization in a Destination City

Impact of COVID-19 pandemic on emergency department visits and infant health: a scoping review protocol

Contact Info

Product

Resources

About