Ohnishi Takuma, Kinoshita Mari, Narumi Satoshi
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Department of Pediatrics, National Hospital Organization Saitama Hospital, Wako, Japan.
Acta Paediatr. 2025 Jun;114(6):1135-1142. doi: 10.1111/apa.17533. Epub 2024 Dec 4.
To quantify the impact of the COVID-19 pandemic on paediatric care use compared to adult care and identify affected subdomains.
Data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for six fiscal years (FY2016-2021) were analysed. Pre-pandemic (FY2016-FY2019) and pandemic years (FY2020, FY2021) were compared to delineate changes in medical services for paediatric and adult patients. Virtually all individuals who received medical care in Japan during this period were included.
In FY2019, healthcare utilisation by the paediatric population (under 15 years) accounted for 24% of 245 million first outpatient visits, 7% of 1.2 billion follow-up visits, and 2.6% of 297 million patient-days hospitalisations. In FY2020, outpatient visits of those aged 0-4 years decreased by 44% (first visit) and 24% (follow-up visit) compared to FY2019, and hospitalisations decreased by 47%, with the largest declines observed in community medical institutions across all age groups.
The COVID-19 pandemic led to a substantial reduction in paediatric healthcare utilisation in Japan, varying by age and type of care. These findings may inform the rational allocation of healthcare resources during public health emergencies.
与成人医疗相比，量化2019冠状病毒病大流行对儿科医疗使用的影响，并确定受影响的子领域。
分析了日本国民健康保险索赔和特定健康检查国家数据库（NDB）六个财政年度（2016财年至2021财年）的数据。比较了疫情前（2016财年至2019财年）和疫情期间（2020财年、2021财年）的数据，以描绘儿科和成人患者医疗服务的变化。在此期间，几乎所有在日本接受医疗护理的个人都被纳入。
2019财年，儿科人群（15岁以下）的医疗利用率占2.45亿次首次门诊就诊的24%、12亿次随访就诊的7%以及2.97亿患者日住院的2.6%。2020财年，与2019财年相比，0至4岁儿童的门诊就诊次数（首次就诊）减少了44%，（随访就诊）减少了24%，住院次数减少了47%，所有年龄组中社区医疗机构的降幅最大。
2019冠状病毒病大流行导致日本儿科医疗利用率大幅下降，因年龄和医疗类型而异。这些发现可能为公共卫生紧急情况期间医疗资源的合理分配提供参考。
