The effect of the COVID-19 pandemic on pediatric emergency department utilization in three regions in Switzerland.

Autor: von Rhein M; Child Development Center, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland. michael.vonrhein@kispi.uzh.ch., Chaouch A; Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland., Oros V; University Children`S Hospital Zurich, University of Zurich, Zurich, Switzerland., Manzano S; Pediatric Emergency Department, Geneva University Hospitals, University of Geneva, Geneva, Switzerland., Gualco G; Pediatric Emergency Departement, Clinics of Pediatrics, Institute of Pediatrics of Southern Switzerland, EOC, Bellinzona, Switzerland., Sidler M; Private Practice, Binningen, Switzerland., Laasner U; Private Practice, Winterthur, Switzerland., Dey M; School of Health Science, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland., Dratva J; School of Health Science, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.; Medical Faculty, University of Basel, Basel, Switzerland., Seiler M; Pediatric Emergency Department, University Children`S Hospital Zurich, University of Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: International journal of emergency medicine [Int J Emerg Med] 2024 May 16; Vol. 17 (1), pp. 64. Date of Electronic Publication: 2024 May 16.
DOI: 10.1186/s12245-024-00640-2
Abstrakt: Purpose: The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare.
Methods: We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018-February 28th, 2022), analyzing the numbers of ED visits (including patients` age, triage categories, and urgent vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utilization was assessed by interrupted time series (ITS) modelling.
Results: Based on 304'438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual recovery. This primarily affected children 0-4 years, and both non-urgent and urgent cases. However, the decline in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic.
Conclusions: The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, particularly among children 0-4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pandemic. Furthermore, future policy decisions should take regional differences into account.
(© 2024. The Author(s).)
Databáze: MEDLINE
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