Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA.
Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA.
Int J Environ Res Public Health. 2021 May 27;18(11):5734. doi: 10.3390/ijerph18115734.
We aimed to determine how COVID-19 affected the number and type of pediatric primary care visits in April 2020, compared to April 2019, and which characteristics were associated with obtaining care in 2020. We performed a retrospective chart review of patients receiving care in April 2019 and April 2020 from four large, academic institutions across two states. The subjects were included if they were aged 0-18 years and were seen in a pediatric clinic in April 2019 or April 2020. We extracted the number of visits, visit type, and visit diagnosis; and the patient characteristics, including age, race/ethnicity, and insurance status. Logistic regression analysis identified characteristics associated with obtaining care in April 2020. We included 120,230 visits. Participants were 50% white and half had Medicaid. In 2020 there were significantly fewer visits for both well and acute visits with 42,670 visits in 2020 compared to 77,560 in 2019; 6616 were telehealth visits in 2020. Visits for chronic conditions were significantly decreased in 2020. Attending a visit in 2020 was more likely if the participant was black or Hispanic, younger, attending an acute visit, or had private insurance. During the COVID-19 pandemic, pediatric primary care decreased substantially for both well visits and follow-up of chronic conditions.
我们旨在确定与 2019 年 4 月相比，2020 年 4 月 COVID-19 如何影响儿科初级保健就诊的数量和类型，以及哪些特征与 2020 年获得护理相关。我们对来自两个州的四个大型学术机构 2019 年 4 月和 2020 年 4 月接受护理的患者进行了回顾性图表审查。如果患者年龄在 0-18 岁之间，并在 2019 年 4 月或 2020 年 4 月在儿科诊所就诊，则将其纳入研究。我们提取了就诊次数、就诊类型和就诊诊断；以及患者特征，包括年龄、种族/族裔和保险状况。逻辑回归分析确定了与 2020 年获得护理相关的特征。我们共纳入了 120230 次就诊。参与者中 50%为白人，一半为医疗补助计划（Medicaid）。与 2019 年相比，2020 年的健康和急性就诊次数明显减少，2020 年有 42670 次就诊，而 2019 年有 77560 次就诊；2020 年有 6616 次远程医疗就诊。2020 年慢性疾病就诊次数明显减少。如果参与者是黑人或西班牙裔、年龄较小、就诊为急性就诊或拥有私人保险，则更有可能在 2020 年就诊。在 COVID-19 大流行期间，无论是健康就诊还是慢性疾病随访，儿科初级保健就诊都大幅减少。
