Seiler Michelle, Biland Gregory, Gruebner Oliver, Manzano Sergio, Gualco Gianluca, Sidler Marc, Laasner Ursula, Dratva Julia, von Rhein Michael
University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Geography, University of Zurich, Zurich, Switzerland.
Front Public Health. 2025 Aug 14;13:1574208. doi: 10.3389/fpubh.2025.1574208. eCollection 2025.
The Swiss government implemented lockdown measures during the COVID-19 pandemic to contain outbreaks and prevent healthcare system overload. Emergency department (ED) visits were discouraged, leading to a decline in utilization, except for urgent cases. However, little is known about regional variations in pediatric ED use and spatial distribution patterns across Switzerland. This study aimed to analyze changes in pediatric ED catchment areas over time across three Swiss centers and explore implications for future healthcare crises.
We conducted a retrospective, longitudinal cohort study at three tertiary pediatric EDs in Zurich, Bellinzona, and Geneva, covering different language regions. Data from March 2018 to February 2022 included daily pediatric ED visits, patient demographics, and postal codes. We categorized the timeline into pre-pandemic (before March 11, 2020), pandemic (March 11, 2020 - March 22, 2021), and post-pandemic (after March 22, 2021) phases. Travel distances were analyzed using driving distance matrices along the Swiss road network, and geovisualization techniques were applied to illustrate regional variations and policy impacts.
Among 294,409 recorded ED visits (158,643 in Zurich, 32,332 in Bellinzona, 103,434 in Geneva), ED visits declined by approximately 50% during the lockdown. Before the pandemic, patients living closer to hospitals visited more frequently. During the pandemic, the decline was most pronounced among nearby residents, while post-pandemic utilization shifted toward patients living farther away. Regional differences were observed: travel distances remained stable in Zurich; in Bellinzona, they increased by nearly 11%; and decreased by 3% in Geneva.
The pandemic significantly influenced pediatric ED utilization in Switzerland, with long-term shifts in healthcare-seeking behavior. Despite uniform national regulations, utilization patterns varied across language regions, suggesting multifactorial influences. Geographic visualization provided insights into catchment area changes, offering a valuable tool for healthcare planning. These findings highlight the need for region-specific strategies in future healthcare crises, and our approach can be applied to other Swiss regions and similar global settings.
瑞士政府在新冠疫情期间实施了封锁措施，以控制疫情爆发并防止医疗系统不堪重负。除紧急情况外，不鼓励前往急诊科就诊，这导致了就诊率下降。然而，瑞士儿科急诊科使用情况的地区差异以及空间分布模式鲜为人知。本研究旨在分析瑞士三个中心儿科急诊科服务范围随时间的变化，并探讨其对未来医疗危机的影响。
我们在苏黎世、贝林佐纳和日内瓦的三个三级儿科急诊科进行了一项回顾性纵向队列研究，这些急诊科覆盖不同语言区域。2018年3月至2022年2月的数据包括每日儿科急诊科就诊情况、患者人口统计学信息和邮政编码。我们将时间线分为疫情前（2020年3月11日前）、疫情期间（2020年3月11日至2021年3月22日）和疫情后（2021年3月22日后）阶段。使用瑞士公路网的驾车距离矩阵分析出行距离，并应用地理可视化技术来说明地区差异和政策影响。
在记录的294,409次急诊科就诊中（苏黎世158,643次、贝林佐纳32,332次、日内瓦103,434次），封锁期间急诊科就诊量下降了约50%。在疫情之前，居住在离医院较近的患者就诊更频繁。在疫情期间，附近居民的就诊量下降最为明显，而疫情后就诊量转向了居住较远的患者。观察到地区差异：苏黎世的出行距离保持稳定；在贝林佐纳，出行距离增加了近11%；在日内瓦则下降了3%。
疫情对瑞士儿科急诊科的使用产生了重大影响，患者就医行为发生了长期变化。尽管有统一的国家规定，但不同语言区域的使用模式各不相同，这表明存在多因素影响。地理可视化提供了有关服务范围变化 的见解，为医疗规划提供了有价值的工具。这些发现凸显了在未来医疗危机中制定针对特定地区策略的必要性，我们的方法可应用于瑞士其他地区和类似的全球环境。
