在 COVID-19 大流行期间，艾伯塔省急诊部门因儿童心理健康问题就诊情况：与学校关闭和重新开放相关的就诊趋势研究。

Visits to Alberta Emergency Departments for Child Mental Health Concerns During the COVID-19 Pandemic: An Examination of Visit Trends in Relation to School Closures and Reopenings.

机构信息

From the Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Departments of Pediatrics and Emergency Medicine.

出版信息

Pediatr Emerg Care. 2023 Jul 1;39(7):542-547. doi: 10.1097/PEC.0000000000002979. Epub 2023 May 28.

DOI:10.1097/PEC.0000000000002979

PMID:37246141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10317191/

Abstract

OBJECTIVE

We examined emergency department (ED) mental health visit trends by children in relation to periods of school closure and reopening during the COVID-19 pandemic in Alberta, Canada.

METHODS

Mental health visits by school-aged children (5 to <18 years) were extracted from the Emergency Department Information System, a province-wide database, from March 11, 2020, to November 30, 2021 (pandemic period; n = 18,997) and March 1, 2019, to March 10, 2020 (1-year, prepandemic comparator period; n = 11,540). We calculated age-specific visit rates and compared rate differences between periods of school closure (March 15-June 30, 2020; November 30, 2020-January 10, 2021; April 22-June 30, 2021) and reopening (September 4-November 29, 2020; January 11-April 21, 2021; September 3-November 30, 2021) to matched prepandemic periods. We used a ratio of relative risk to examine the risk of a visit during closures versus reopenings.

RESULTS

The cohort included 11,540 prepandemic visits and 18,997 pandemic visits. Compared with prepandemic periods, ED visit rates increased across all ages during the first (+85.53%; 95% confidence interval [CI], 73.68% to 100.41%) and third (+19.92%; 95% CI, 13.28% to 26.95%) school closures, and decreased during the second closure (-15.37%; 95% CI, -22.22% to -7.92%). During school reopenings, visit rates decreased across all ages during the first reopening (-9.30%; 95% CI, -13.94% to -4.41%) and increased during the third reopening (+13.59%; 95% CI, 8.13% to 19.34%); rates did not change significantly during the second reopening (2.54%; 95% CI, -3.45% to 8.90%). The risk of a visit during school closure versus reopening was only higher for the first closure with 2.06 times the risk (95% CI, 1.88 to 2.25).

CONCLUSIONS

Emergency department mental health visit rates were highest during the first school closure of the COVID-19 pandemic, and the risk of a visit during this closure period was twice compared with when schools first reopened.

摘要

目的

我们考察了加拿大艾伯塔省 COVID-19 大流行期间与学校关闭和重新开放相关的儿童急诊（ED）心理健康就诊趋势。

方法

从 2020 年 3 月 11 日至 2021 年 11 月 30 日（大流行期间；n=18997）和 2019 年 3 月 1 日至 2020 年 3 月 10 日（1 年，大流行前对照组；n=11540），从全省范围内的急诊信息系统中提取了 5 至<18 岁儿童的心理健康就诊信息。我们计算了年龄特异性就诊率，并比较了学校关闭（2020 年 3 月 15 日至 6 月 30 日；2020 年 11 月 30 日至 1 月 10 日；2021 年 4 月 22 日至 6 月 30 日）和重新开放（2020 年 9 月 4 日至 11 月 29 日；2021 年 1 月 11 日至 4 月 21 日；2021 年 9 月 3 日至 11 月 30 日）与大流行前同期的就诊率差异。我们使用相对风险比来检查关闭期与重新开放期就诊的风险。

结果

该队列包括 11540 例大流行前就诊和 18997 例大流行就诊。与大流行前相比，在第一次（+85.53%；95%置信区间[CI]，73.68%至 100.41%）和第三次（+19.92%；95%CI，13.28%至 26.95%）学校关闭期间，所有年龄段的 ED 就诊率均增加，而在第二次关闭期间（-15.37%；95%CI，-22.22%至-7.92%）则减少。在重新开放期间，所有年龄段的就诊率在第一次重新开放期间均下降（-9.30%；95%CI，-13.94%至-4.41%），在第三次重新开放期间上升（+13.59%；95%CI，8.13%至 19.34%）；第二次重新开放期间就诊率没有显著变化（2.54%；95%CI，-3.45%至 8.90%）。与学校首次重新开放相比，仅在第一次关闭期间就诊的风险更高，风险比为 2.06（95%CI，1.88 至 2.25）。