Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Stanford University School of Medicine, Stanford, CA.
Fam Med. 2023 Oct;55(9):620-624. doi: 10.22454/FamMed.2023.755040. Epub 2023 Jul 24.
The COVID-19 pandemic impacted the volume and nature of pediatric primary care visits nationwide. This study aimed to identify trends in pediatric visits at our institution during the pandemic to reveal opportunities to improve care of children and adolescents.
We performed a retrospective chart review of all pediatric visits conducted at a single family medicine clinic within a large academic medical center in Northern California from January 1, 2019, through September 30, 2021. Data collected for each visit included age, sex, type of visit (preventive or problem-focused), reason for visit (if problem-focused), and mode of visit (in-person or telehealth). We analyzed data using descriptive statistics and χ2 tests.
A total of 4,844 pediatric visits occurred during the study period. Visit volume dropped 9% from 2019 to 2020 and recovered to prepandemic levels in 2021. During the study period from 2019 to 2021, the percentage of problem-focused visits increased from 30% to 37% (P=.008) among adolescents, driven largely by an increase in the percentage of behavioral health visits from 14% to 29% (P<.001). We found no significant changes in the age or sex of patients seen. Telemedicine visit volume decreased from 2020 to 2021 in all age categories except for adolescents, which remained stable at 43% of all visits.
A sharp increase in behavioral health concerns among adolescents stands out as the most notable impact of COVID-19 on pediatric care at our institution. Our findings raise questions about how behavioral health care can be optimized for adolescents in the postpandemic era.
COVID-19 大流行对全美儿科初级保健就诊量和性质产生了影响。本研究旨在确定我院在大流行期间儿科就诊的趋势，以发现改善儿童和青少年护理的机会。
我们对北加州一家大型学术医疗中心的单一家庭医学诊所 2019 年 1 月 1 日至 2021 年 9 月 30 日期间进行的所有儿科就诊进行了回顾性图表审查。每次就诊收集的数据包括年龄、性别、就诊类型（预防或问题为重点）、就诊原因（如果为问题为重点）和就诊方式（亲自或远程医疗）。我们使用描述性统计和 χ2 检验分析数据。
研究期间共进行了 4844 次儿科就诊。就诊量从 2019 年到 2020 年下降了 9%，并在 2021 年恢复到大流行前的水平。在 2019 年至 2021 年期间，青少年中以问题为重点的就诊比例从 30%增加到 37%（P=.008），主要是由于行为健康就诊比例从 14%增加到 29%（P<.001）。我们发现就诊患者的年龄或性别没有显著变化。除青少年外，所有年龄段的远程医疗就诊量均从 2020 年下降到 2021 年，而青少年的就诊量则稳定在所有就诊量的 43%。
青少年中行为健康问题的急剧增加是 COVID-19 对我院儿科护理最显著的影响。我们的研究结果提出了关于如何在大流行后优化青少年行为保健的问题。
