Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance

Therese McDonnell, Emma Nicholson, Ciara Conlon, Michael Barrett, Fergal Cummins, Conor Hensey and Eilish McAuliffe
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Emma Nicholson: Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, D04 C7X2 Dublin, Ireland
Ciara Conlon: Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, D04 C7X2 Dublin, Ireland
Michael Barrett: Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland
Fergal Cummins: REDSPOT (Retrieval, Emergency and Disaster Medicine Research and Development), Emergency Department, Limerick University Hospital, V94 F858 Limerick, Ireland
Conor Hensey: Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland
Eilish McAuliffe: Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, D04 C7X2 Dublin, Ireland

IJERPH, 2020, vol. 17, issue 18, 1-24

Abstract: This study outlines the impact of COVID-19 on paediatric emergency department (ED) utilisation and assesses the extent of healthcare avoidance during each stage of the public health response strategy. Records from five EDs and one urgent care centre in Ireland, representing approximately 48% of national annual public paediatric ED attendances, are analysed to determine changes in characteristics of attendance during the three month period following the first reported COVID-19 case in Ireland, with reference to specific national public health stages. ED attendance reduced by 27–62% across all categories of diagnosis in the Delay phase and remained significantly below prior year levels as the country began Phase One of Reopening, with an incident rate ratio (IRR) of 0.58. The decrease was predominantly attributable to reduced attendance for injury and viral/viral induced conditions resulting from changed living conditions imposed by the public health response. However, attendance for complex chronic conditions also reduced and had yet to return to pre-COVID levels as reopening began. Attendances referred by general practitioners (GPs) dropped by 13 percentage points in the Delay phase and remained at that level. While changes in living conditions explain much of the decrease in overall attendance and in GP referrals, reduced attendance for complex chronic conditions may indicate avoidance behaviour and continued surveillance is necessary.

Keywords: COVID-19; paediatric; public health; emergency medicine; delayed attendance; avoidance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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