Evaluation of changes in pediatric healthcare activity during the Covid-19 state of alarm in the Canary Islands

Abstract

Objective: During the SARS-CoV-2 state of alarm (SoA), a 30–70% reduction was observed in the number of visits to Pediatric Emergency Departments (ED), as well as frequent delay in diagnosis or difficulty accessing healthcare services. Here we evaluate modifications observed in pediatric healthcare activity during the SoA. Study design: Descriptive retrospective observational study of the hospital pediatric activity. Method: We compared the use of pediatric healthcare services during the SoA (March 11th – June 25th, 2020) versus the use during the equivalent periods of years 2018 and 2019, in the “Complejo Hospitalario Universitario Insular Materno Infantil de Canarias” (Mother and Child University Hospital of the Canary Islands). Results: The number of patients visiting the pediatric ED decreased by 66.75% on average (95%CI: -65.6; - 67.7; p < 0.001), with a peak reduction (70.4%; 95%CI: -69.0; −71.7; p < 0.001) during the lockdown. We observed an increase in the number of cases of psychiatric disorders, foreign body ingestions and intoxications, as well as a decrease in respiratory conditions. Hospital admissions decreased by 45.5% (95%CI: - 38.9; −51.3; p < 0.001), while the ratio and duration of hospital stay increased. A proportion of 3.95% of admitted patients experienced complications caused by delayed visit to the ED. Conclusions: The study shows that more patient education campaigns are needed to improve the efficiency of emergency services. It is important to reinforce the message that adequate healthcare service management is necessary.

Keywords

• Healthcare utilization
• Emergency care
• COVID-19
• Emergency department
• Overcrowding