(O-I4) Changes in Pediatric Emergency Department Visits After Arrival of COVID-19

Objectives: Our goal was to examine the changes in pediatric ED visits after the arrival of COVID-19.

Background: COVID-19 arrived in the New York metropolitan area in early March 2020. Shortly thereafter total ED visits markedly decreased likely due to public health mandates and fear of contracting COVID-19. Our goal was to examine the changes in pediatric ED visits after the arrival of COVID-19.

Methods:

Design: retrospective cohort. Setting: EDs of 8 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban and urban settings. Annual ED volumes ranged from 30,000 to 122,000. Population: Consecutive ED visits for patients ages 0-21 years, for the time period from March 1 through November 30 in 2019 -2022, as COVID-19 arrived in early March 2020. Protocol: We tallied total pediatric ED visits for the time periods in each year. We calculated the percent changes from the base year, 2019, for each of the years 2020-2022 along with 95% confidence intervals (CIs).

Results: The database contained a total of 332,504 visits: 110,210 in 2019, 55,270 in 2020, 71,570 in 2021, and 93,512 in 2022. Average age by year ranged from a low of 8.8 years in 2022 to a high of 10.5 years in 2020. The percent of female patients ranged from a low of 47% in 2022 to a high of 49% in 2020. The percent changes in visits from 2019 were: -49.9% (95% CI, -49.6, -50.2%); -35.1% (-34.8, -35.3%); and -15.2% (-14.9, -15.4%), for the years 2020, 2021 and 2022, respectively.

Conclusions: The number of pediatric ED visits changed after arrival of COVID-19. There was a marked decrease in 2020. This decrease was partially reversed in 2021 and 2022, although the visits did not reach their pre-pandemic levels. Since public health mandates have been relaxed, we speculate that failure to return to the pre-pandemic number of visits is likely due to preferential use of other sources of care, including doctor’s offices, urgent care centers and telemedicine.

References (Optional):

Funding (Optional): None