The impact of the COVID-19 pandemic on paediatric health service use within one year after the first pandemic outbreak in New South Wales Australia – a time series analysis

Hu, Nan; Nassar, Natasha; Shrapnel, Jane; Perkes, Iain; Hodgins, Michael; O’Leary, Fenton; Trudgett, Carla; Eapen, Valsamma; Woolfenden, Sue; Knight, Katherine; Lingam, Raghu

doi:10.1016/j.lanwpc.2021.100311

Cited by 38 publications

(46 citation statements)

References 39 publications

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“…Several studies reported reduced pediatric health care contacts, emergency department (ED) presentations, admissions, and pediatric intensive care admissions in Italy, the UK, Scotland, and Australia during local lockdowns [2,[10][11][12][13], mainly driven by substantial reductions in respiratory diseases. Trauma-specific investigations from several countries (UK, Ireland, Canada, New Zealand) showed decreases up to 60% for pediatric trauma presentations to EDs [4,[14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

et al. 2022

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Children’s and adolescents’ lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017–2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85–1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93–1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57–1.02 and 0.26 (0.05–0.75)), whereas household and leisure accidents increased (1.33 (1.06–1.66) and 1.34 (1.06–1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38–1.16) and 2.09 (1.19–3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42–1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51–3.02)), but decreased in adolescent girls (0.56 (0.32–0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation.

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Section: Discussionmentioning

confidence: 99%

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

et al. 2022

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“…These results coincide with those obtained in Australia and the US. (13,25) In fact, an increase in MHR ED utilization among adolescent girls aged 12-17 years was also seen in New South Wales during the first year of the pandemic (January 2020 to February 2021). ( 13) Weekly ED visits for adolescent girls also increased for eating and tic disorders in 2020-2021 and depression and obsessive-compulsive disorder in 2021 compared to 2019 in the US.…”

Section: Discussionmentioning

confidence: 99%

“…(5) Large fluctuations in pediatric emergency department (ED) utilization have been observed. (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) Pediatric EDs are integral to the assessment, treatment and coordination of care for children and adolescents, and often serve as a safety net for vulnerable and underserved patients. (18) Increasingly, EDs also play a pivotal role in pediatric mental health emergencies, as exemplified by the rising pre-pandemic trends in mental health-related (MHR) ED visits documented in the last decade.…”

Section: Introductionmentioning

confidence: 99%

“…While both MHR and overall ED visits first decreased during 2020, (7-12, 14-17, 21-24) some studies have reported increased MHR ED utilization during 2021 and early 2022. (13,25) During this time, overall pediatric ED utilization has remained lower than pre-COVID-19 levels. (6,25) So far, the bulk of the evidence regarding changes in pediatric MHR ED utilization has originated from the United States, thereby limiting the generalisability of findings to other countries.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada before and during the COVID-19 pandemic

Beaudry

Drouin

Gravel

et al. 2022

Preprint

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BackgroundReports on longitudinal trends in mental health–related (MHR) emergency department (ED) utilization spanning the pre- and post-pandemic periods are lacking, along with evidence comparing healthcare services utilization by sociodemographic subgroups. The aim of this study was to evaluate COVID-19–associated changes in MHR ED utilization among youth overall and by age, sex, and socioeconomic status (SES).MethodsThis retrospective cross-sectional study analyzed MHR ED utilization before and during the COVID-19 pandemic at a large urban pediatric tertiary care hospital in Montréal, Canada. All ED visits for children (5–11 years) and adolescents (12–17 years) between April 1, 2016 and November 30, 2021 were included. The main outcome was the monthly count of MHR ED visits. Pre-pandemic and pandemic periods were compared using an interrupted time series design. The effect of seasonality (in months), age (in years), sex (male or female), and SES (low, average, high) were compared using a generalized additive model.ResultsThere were a total of 437,147 ED visits (204,215 unique patients) during the five-year study period of which 9,748 (5.8%) were MHR visits (7,686 unique patients). We observed an increase of 69% (95% CI, +53% to +85%; p = .001) in the mean monthly count of MHR ED visits during the pandemic period, which remained significant after adjusting for seasonality (44% increase, 95% CI, +38% to +51%; p = .001). The chance of presenting for a MHR ED visit increased non-linearly with age. There were increased odds of presenting for a MHR ED visit among girls between the pre-pandemic and pandemic periods (OR 1.42, 95% CI 1.29–1.56). No difference by SES group during and before the COVID-19 pandemic was found (OR 1.01, 95% CI 0.89–1.15 [low]; OR 1.09, 95% CI 0.96–1.25 [high]).ConclusionsOur study shows important increases in MHR ED utilization among youth, and especially among girls, during the first 20 months of the COVID-19 pandemic, highlighting the need for sustained, targeted and scalable mental health resources to support youth mental health during the current and future crises.

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Associations between ongoing COVID‐19 lockdown and the financial and mental health experiences of Australian families

Price

Suárez

Zhu

et al. 2022

Aust J Social Issues

Self Cite

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In 2020, Australia's successful COVID‐19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler‐6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference‐in‐difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler‐6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school‐aged children (vs. pre‐/high‐school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence‐informed financial and mental health supports.

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The impact of the COVID-19 pandemic on paediatric health service use within one year after the first pandemic outbreak in New South Wales Australia – a time series analysis

Cited by 38 publications

References 39 publications

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada before and during the COVID-19 pandemic

Associations between ongoing COVID‐19 lockdown and the financial and mental health experiences of Australian families

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