von Rhein Michael, Chaouch Aziz, Oros Vivian, Manzano Sergio, Gualco Gianluca, Sidler Marc, Laasner Ursula, Dey Michelle, Dratva Julia, Seiler Michelle
Child Development Center, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Int J Emerg Med. 2024 May 16;17(1):64. doi: 10.1186/s12245-024-00640-2.
The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare.
We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018-February 28th, 2022), analyzing the numbers of ED visits (including patients` age, triage categories, and urgent vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utilization was assessed by interrupted time series (ITS) modelling.
Based on 304'438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual recovery. This primarily affected children 0-4 years, and both non-urgent and urgent cases. However, the decline in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic.
The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, particularly among children 0-4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pandemic. Furthermore, future policy decisions should take regional differences into account.
新冠疫情与急诊科就诊人数减少有关。然而，关于儿童的相互矛盾且稀少的数据尚无法回答在整个疫情期间儿科急诊科的使用情况是如何演变的这一问题。我们的目标是通过分析随时间变化的趋势来调查疫情对瑞士三个语言区的影响，描述地区差异，并探讨对未来医疗保健的影响。
我们在瑞士的三家三级儿科急诊科进行了一项回顾性纵向队列研究（2018年3月1日至2022年2月28日），分析急诊科就诊人数（包括患者年龄、分诊类别以及急症与非急症病例）。通过中断时间序列（ITS）模型评估与新冠疫情相关的非药物干预措施（NPIs）对儿科急诊科使用情况的影响。
基于304438次急诊科就诊数据，我们发现在实施非药物干预措施之初就诊人数下降了近50%，随后逐渐恢复。这主要影响了0至4岁的儿童以及非急症和急症病例。然而，与第三个中心相比，另外两个中心的急症就诊人数下降似乎更为明显，在第三个中心，疫情期间住院率也没有显著下降。亚组分析显示，疫情期间呼吸道和胃肠道疾病显著减少，创伤患者的比例增加。
新冠疫情对儿科急诊科就诊人数和原因产生了重大影响，尤其是在0至4岁的儿童中。尽管监管条件相同，但三个地区的使用动态差异显著，这突出了疫情期间儿科急诊科使用情况的多因素变化。此外，未来的政策决策应考虑地区差异。
