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Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore
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 reso...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755581/ https://www.ncbi.nlm.nih.gov/pubmed/33353540 http://dx.doi.org/10.1186/s12887-020-02469-z |
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author | Chong, Shu-Ling Soo, Jenifer Shui Lian Allen, John Carson Ganapathy, Sashikumar Lee, Khai Pin Tyebally, Arif Yung, Chee Fu Thoon, Koh Cheng Ng, Yong Hong Oh, Jean Yin Teoh, Oon Hoe Mok, Yee Hui Chan, Yoke Hwee |
author_facet | Chong, Shu-Ling Soo, Jenifer Shui Lian Allen, John Carson Ganapathy, Sashikumar Lee, Khai Pin Tyebally, Arif Yung, Chee Fu Thoon, Koh Cheng Ng, Yong Hong Oh, Jean Yin Teoh, Oon Hoe Mok, Yee Hui Chan, Yoke Hwee |
author_sort | Chong, Shu-Ling |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-020-02469-z. |
format | Online Article Text |
id | pubmed-7755581 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77555812020-12-23 Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore Chong, Shu-Ling Soo, Jenifer Shui Lian Allen, John Carson Ganapathy, Sashikumar Lee, Khai Pin Tyebally, Arif Yung, Chee Fu Thoon, Koh Cheng Ng, Yong Hong Oh, Jean Yin Teoh, Oon Hoe Mok, Yee Hui Chan, Yoke Hwee BMC Pediatr Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-020-02469-z. BioMed Central 2020-12-23 /pmc/articles/PMC7755581/ /pubmed/33353540 http://dx.doi.org/10.1186/s12887-020-02469-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Chong, Shu-Ling Soo, Jenifer Shui Lian Allen, John Carson Ganapathy, Sashikumar Lee, Khai Pin Tyebally, Arif Yung, Chee Fu Thoon, Koh Cheng Ng, Yong Hong Oh, Jean Yin Teoh, Oon Hoe Mok, Yee Hui Chan, Yoke Hwee Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title | Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title_full | Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title_fullStr | Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title_full_unstemmed | Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title_short | Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore |
title_sort | impact of covid-19 on pediatric emergencies and hospitalizations in singapore |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755581/ https://www.ncbi.nlm.nih.gov/pubmed/33353540 http://dx.doi.org/10.1186/s12887-020-02469-z |
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