Solanke Folasade, Easton Stephanie, Selby Anna, James David, Roberts Graham
Faculty of Medicine, University of Southampton, Southampton, UK.
Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Arch Dis Child. 2023 May 3;107(10):e1-e7. doi: 10.1136/archdischild-2021-323389.
There 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.
We 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.
There 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.
During 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.
NCT04893122.
有人担心新冠疫情正在对年轻人产生间接负面影响。我们旨在评估该疫情对急诊科就诊和住院情况的影响。
我们分析了5年期间（2016年4月至2021年2月）的急诊科就诊和住院情况。采用中断时间序列分析，利用第1年至第4年的数据来估计在没有疫情的情况下第5年本应出现的就诊和住院情况。这些估计值用于计算疫情期间预期就诊和住院情况与实际观察到的就诊和住院情况之间的差异。
5年期间共有166459次就诊。疫情期间就诊次数减少了38.1%（95%置信区间为33.9%至42.3%），且在性别、年龄、贫困程度或种族方面无差异。最大降幅与儿童在家接受教育有关，而非与封锁措施有关。对于住院情况，减少了23.4%（17.4%至29.4%），5至17岁年龄组的降幅较小。感染和哮喘/喘息就诊次数减少了约60%，心理健康和创伤方面的降幅较小。外科就诊、烧伤/烫伤或过敏反应方面没有变化。疫情期间，11至17岁出现心理健康问题的女性有所增加。
疫情期间，急诊科就诊和住院情况均大幅减少。对特定就诊情况的不同影响表明，这是由于社交距离和社交活动减少的影响，而非健康不平等加剧或就医障碍增加。
NCT04893122。
