Changes in Developmental-Behavioral Pediatric Referral Trends from a non-Western Country during the Covid-19 Pandemic

Abstract

Objectives The global spread of COVID-19 and associated policies have caused negative factors at the level of children, families, and services, resulting in physical, mental, and developmental issues in children, as well as limited access to healthcare. We evaluated the referral numbers, sources, and trends of a developmental-behavioral pediatrics (DBP) department in Turkey as a Eurasian country, as well as the effects of the COVID-19 pandemic on referral variables. Methods This longitudinal observational research examined patient referral data to Hacettepe University Developmental-Behavioral Pediatrics Department (HUDPD) between 2014 and 2021. We analyzed the changes in the number of referrals over time in 3-month intervals using negative binomial regression models (NBR). The impact of the COVID-19 pandemic on referral reasons was evaluated. Results The overall number of referrals increased by 1.040-fold [95% confidence interval (CI) 1.015–1.067] per year. There was a 1.070 (95% CI: 1.033–1.110)-fold increase per year before the pandemic, and a 1.077 (95% CI: 0.933–1.24)-fold increase afterward. Referrals for perinatal-neonatal risks were 1.359 (95% CI: 1.269–1.456) times higher than in the pre-pandemic period, and those for suspected autism were 1.209 (95% CI: 0.987–1.478) times higher. Conclusion Although it is encouraging that our referral trends have improved in the 1.5 years since the COVID-19 pandemic, it is thought that health service constraints caused a considerable increase in prenatal risk and suspicion of autism referrals following the pandemic. Improvement and innovation in healthcare systems to prevent the long-term detrimental impacts of periodic interruptions in healthcare on children's development and behavior is needed.