Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Pediatr Pulmonol. 2021 Jul;56(7):1951-1956. doi: 10.1002/ppul.25406. Epub 2021 Apr 13.
The Coronavirus disease 2019 (COVID-19) pandemic profoundly impacted health care utilization. We evaluated asthma-related emergency department (ED) and inpatient health care utilization by a county-specific Medicaid population, ages 2-18, during the COVID-19 pandemic and compared it to utilization from a 3-year average including 2017-2019. All-cause ED utilization and asthma medication fill rates were evaluated during the same timeframes. Relative to the 2017-2019 3-year average, cumulative asthma-related ED visits from January through June decreased by 45.8% (p = .03) and inpatient admission rates decreased by 50.5% (p = .03). The decline in asthma-related ED utilization was greater than the reduction of overall ED use during the same time period, suggesting that the decline involved factors specific to asthma and was not due solely to avoidance of health care facilities. Fill rates for asthma controller medications decreased during this time (p = .03) and quick relief medication fill rates had no significant change (p = .31). Multiple factors may have contributed to the decrease in acute asthma health care visits. Locally, decreased air pollution and viral exposures coincided with the "Stay-at-home" order in Ohio, and increased utilization of telehealth for assessment during exacerbations may have impacted outcomes. Identification of the cause of the decline in visit rates could spur new interventions to limit the need for ED and inpatient visits for asthma patients, leading to both economic and health-associated benefits.
2019 年冠状病毒病（COVID-19）大流行深刻影响了医疗保健的利用。我们评估了特定县的医疗补助人群（2-18 岁）在 COVID-19 大流行期间与哮喘相关的急诊部（ED）和住院医疗保健的利用情况，并将其与包括 2017-2019 年在内的 3 年平均值进行了比较。在相同的时间框架内评估了所有原因的 ED 利用情况和哮喘药物填充率。与 2017-2019 年 3 年平均值相比，1 月至 6 月期间与哮喘相关的 ED 就诊次数累计减少了 45.8%（p=0.03），住院率下降了 50.5%（p=0.03）。哮喘相关 ED 利用率的下降大于同期总体 ED 使用量的减少，这表明下降涉及哮喘的特定因素，而不仅仅是由于避免使用医疗保健设施。在此期间，哮喘控制药物的填充率下降（p=0.03），而快速缓解药物的填充率没有显著变化（p=0.31）。多种因素可能导致急性哮喘保健就诊次数减少。在当地，俄亥俄州的“就地避难”命令导致空气污染和病毒暴露减少，在病情恶化时，对远程医疗的利用增加可能会影响结果。确定就诊率下降的原因可能会激发新的干预措施，以限制哮喘患者对 ED 和住院就诊的需求，从而带来经济和健康方面的益处。
