Hiscock Harriet, Chu Wanyu, O'Reilly Gerard, Freed Gary L, White Mary, Danchin Margie, Craig Simon
Health Services Research Unit, The Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Vic., 3052, Australia; and Health Services, Murdoch Children's Research Institute, Melbourne, Vic., Australia; and Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.
Health Services Research Unit, The Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Vic., 3052, Australia; and Health Services, Murdoch Children's Research Institute, Melbourne, Vic., Australia.
Aust Health Rev. 2022 Oct;46(5):529-536. doi: 10.1071/AH22015.
Objective To determine the association between coronavirus disease 2019 (COVID-19) restrictions and paediatric mental health emergency department presentations. Methods Secondary analysis of Victorian Emergency Minimum Dataset data from 38 Victorian public hospital emergency departments. Paediatric patients (birth to <18 years) attending emergency departments with an International Classification of Disease-Australian Modification (ICD-10-AM) diagnosis of a mental health problem between 1 January 2018 and 31 October 2020 were included. We compared pre-COVID-19 (1 January 2018-27 March 2020) to the COVID-19 period (28 March-26 October 2020) to examine the number of mental health presentations by patient age, socioeconomic status, location, and emergency department triage category. A Poisson regression prediction model was built for each diagnosis group to predict the presentation number in the COVID-19 period, assuming the pandemic and associated restrictions had not happened. Results There were 15 898 presentations (589 presentations/month on average) in the pre-COVID-19 period and 4747 presentations (678 presentations/month on average) in the COVID-19 period. Compared with predicted presentations, there was an increase in observed presentations for eating disorders throughout lockdown (on average, an increase of 36 presentations/month) and for anxiety (11/month) and self-harm (18/month). There were no meaningful changes for mood disorders or developmental and behavioural problems, and presentations for substance abuse mostly fell. Conclusions Pandemic restrictions were associated with increased emergency department presentations for eating disorders and, to a lesser extent, anxiety and self-harm. Given the ongoing pandemic, clinicians and policy makers must work together to find timely, accessible solutions to better manage these conditions.
目的 确定2019冠状病毒病（COVID-19）限制措施与儿科心理健康急诊就诊之间的关联。方法 对来自维多利亚州38家公立医院急诊科的维多利亚急诊最小数据集数据进行二次分析。纳入2018年1月1日至2020年10月31日期间因心理健康问题在急诊科就诊且诊断依据为《澳大利亚疾病分类修改版国际疾病分类》（ICD-10-AM）的儿科患者（出生至未满18岁）。我们比较了COVID-19之前（2018年1月1日至2020年3月27日）和COVID-19期间（2020年3月28日至10月26日）按患者年龄、社会经济状况、地点和急诊科分诊类别划分的心理健康就诊次数。为每个诊断组建立泊松回归预测模型，以预测在假设大流行及相关限制措施未发生的情况下COVID-19期间的就诊次数。结果 COVID-19之前期间有15898次就诊（平均每月589次就诊），COVID-19期间有4747次就诊（平均每月678次就诊）。与预测就诊次数相比，在整个封锁期间，饮食失调的观察到的就诊次数有所增加（平均每月增加36次就诊），焦虑（每月11次）和自我伤害（每月18次）的就诊次数也有所增加。情绪障碍或发育及行为问题没有显著变化，药物滥用的就诊次数大多下降。结论 大流行限制措施与饮食失调的急诊科就诊次数增加有关，在较小程度上与焦虑和自我伤害就诊次数增加有关。鉴于大流行仍在持续，临床医生和政策制定者必须共同努力，找到及时、可及的解决方案，以更好地管理这些情况。
