Changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic: a multi-center cross-sectional study

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought remarkable disruption to the ways in which healthcare was delivered. This study aimed to examine changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic. METHODS: An electronic survey was conducted among 142 hospitals in Hunan Province, China. Using data from January 1 to April 30, 2019 as a reference, the changes in the number of visits for different types of pediatric healthcare between January 1 and April 30, 2020 were calculated. Changes in the number of admissions for infections and injuries were also evaluated. RESULTS: The total number of pediatric healthcare presentations decreased by 53.3% in the first four months of 2020. The most remarkable reductions were observed in the utilization of emergency room (ranging from –45.7% to –94.9% among three hospital levels) and observation room (–55.8% to –77.7%); neonatal inpatient care experienced the smallest decreases (–21.2% to –25.5%). Approximately 85% of the total reduction in the number of pediatric inpatient admissions was attributable to the reduction in admissions for infections. A 13.3% increase in the number of admissions for injuries was observed among third-level hospitals. CONCLUSIONS: The utilization of all types of pediatric healthcare services in Hunan Province declined markedly after the outbreak of COVID-19. The reasons, consequences, and responses to these changes should be addressed in future studies and actions.