tetano
Editor, Senior Moderator
BMC Pediatr
. 2020 Dec 23;20(1):562.
doi: 10.1186/s12887-020-02469-z.
Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore
Shu-Ling Chong[SUP] 1 2 [/SUP], Jenifer Shui Lian Soo[SUP] 3 [/SUP], John Carson Allen Jr[SUP] 4 [/SUP], Sashikumar Ganapathy[SUP] 5 6 [/SUP], Khai Pin Lee[SUP] 5 6 [/SUP], Arif Tyebally[SUP] 5 6 [/SUP], Chee Fu Yung[SUP] 6 7 [/SUP], Koh Cheng Thoon[SUP] 6 3 [/SUP], Yong Hong Ng[SUP] 6 3 [/SUP], Jean Yin Oh[SUP] 6 8 [/SUP], Oon Hoe Teoh[SUP] 6 8 [/SUP], Yee Hui Mok[SUP] 6 9 [/SUP], Yoke Hwee Chan[SUP] 6 3 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore.
Methods: We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs).
Results: We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001).
Conclusions: We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.
Keywords: COVID-19; Child; Health services; Resource utilization.
. 2020 Dec 23;20(1):562.
doi: 10.1186/s12887-020-02469-z.
Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore
Shu-Ling Chong[SUP] 1 2 [/SUP], Jenifer Shui Lian Soo[SUP] 3 [/SUP], John Carson Allen Jr[SUP] 4 [/SUP], Sashikumar Ganapathy[SUP] 5 6 [/SUP], Khai Pin Lee[SUP] 5 6 [/SUP], Arif Tyebally[SUP] 5 6 [/SUP], Chee Fu Yung[SUP] 6 7 [/SUP], Koh Cheng Thoon[SUP] 6 3 [/SUP], Yong Hong Ng[SUP] 6 3 [/SUP], Jean Yin Oh[SUP] 6 8 [/SUP], Oon Hoe Teoh[SUP] 6 8 [/SUP], Yee Hui Mok[SUP] 6 9 [/SUP], Yoke Hwee Chan[SUP] 6 3 [/SUP]
Affiliations
- PMID: 33353540
- DOI: 10.1186/s12887-020-02469-z
Abstract
Background: Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore.
Methods: We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs).
Results: We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001).
Conclusions: We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.
Keywords: COVID-19; Child; Health services; Resource utilization.