Rady Children's Hospital-San Diego, San Diego, CA, USA.
Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA.
Public Health Rep. 2023 May-Jun;138(3):493-499. doi: 10.1177/00333549221148176. Epub 2023 Feb 3.
Limited data are available on how the closure of pediatric dental clinics because of the COVID-19 pandemic affected hospital pediatric emergency department (ED) visits in the United States. We evaluated changes in dental-related visits at a pediatric ED and associated urgent care centers (UCCs) after the shutdown of a large pediatric dental clinic because of the COVID-19 pandemic.
We conducted a single-center retrospective medical record review of 811 patients aged 0 to 17 years who presented to a pediatric ED or associated UCC at Rady Children's Hospital-San Diego for dental-related concerns from March 19, 2019, through January 17, 2021. Patients were classified into 3 periods: before shutdown, during shutdown, and after shutdown. We collected data on demographic characteristics; codes; dental diagnosis; treatment; and COVID-19 test results. We compared the frequency and proportion of patients seen for dental-related concerns, dental diagnosis, and treatment during the 3 periods.
The proportion of dental-related concerns in the ED doubled during the shutdown (0.7%) and was 1.5 times higher after the shutdown (0.6%) compared with before the shutdown (0.4%; < .001). Significantly more patients were seen in EDs than in UCCs during and after the shutdown than before the shutdown ( = .005). During and after the shutdown, admission to the hospital for antibiotic treatment increased significantly to 6.5% and 7.9%, respectively, compared with before the shutdown (2.8%; = .022), and nonaerosolized procedures and ED/UCC discharge increased to 13.4% and 9.3%, respectively, compared with before the shutdown (6.2%; = .015).
Mitigating future closures of dental offices is important given the shifted burden of dental care to the ED.
关于由于 COVID-19 大流行而关闭儿科牙科诊所如何影响美国医院儿科急诊部（ED）就诊，相关数据有限。我们评估了一家大型儿科牙科诊所因 COVID-19 大流行关闭后，儿科 ED 和相关的紧急护理中心（UCC）的牙科相关就诊量的变化。
我们对 2019 年 3 月 19 日至 2021 年 1 月 17 日期间，因牙科相关问题到圣地亚哥 Rady 儿童医院儿科 ED 或相关 UCC 就诊的 811 名 0 至 17 岁患者的单中心回顾性病历进行了研究。患者被分为 3 个时期：关闭前、关闭期间和关闭后。我们收集了人口统计学特征；代码；牙科诊断；治疗；和 COVID-19 检测结果的数据。我们比较了 3 个时期内牙科相关就诊、牙科诊断和治疗的频率和比例。
关闭期间 ED 看牙相关就诊的比例增加了一倍（0.7%），关闭后增加了 1.5 倍（0.6%），而关闭前为 0.4%（<0.001）。与关闭前相比，关闭期间和关闭后在 ED 就诊的患者明显多于 UCC（=0.005）。与关闭前相比，关闭期间和关闭后，因抗生素治疗住院的患者显著增加，分别增加到 6.5%和 7.9%（=0.022），非气雾化治疗和 ED/UCC 出院分别增加到 13.4%和 9.3%（=0.015）。
鉴于牙科护理负担转移到 ED，未来减少牙科诊所的关闭非常重要。
