Descriptive analysis of a Community Paediatrics Hybrid Telemedicine/Face to Face service during implementation of community mitigation strategies in response to the COVID-19 pandemic

Abstract

Objective To describe reasons patients accessed the hybrid / telemedicine consultation service during the implementation of community mitigation strategies for COVID-19. Methods Patients accessing the hybrid / telemedicine consultation service during September to October 2020 were included. This was a descriptive study looking at morbidity data for these patients. Clinical data were recorded for all community paediatric service patients and percentages of patients accessing the service were recorded. Odds ratios were calculated to compare subgroups. Results A total of 204 consultations were enrolled. Of these, 114 (55.9%) telemedicine and 90 (44.1%) face to face. 99 (48.5%) were new patients. The odds that parents of new patients attending face-to-face consultation was lower compared to existing patients (OR 0.27; 95% CI 0.15-0.49; P 0.0001). A total of 7 children (3.4%) attended face-to-face to complete assessments. 10 (5%) children attended but were not required to be present. Of all the patients, 42 (20.6%) attended for Disability Assistance Grant (DAG) forms to be completed. The odds that a parent of a child with Autism Spectrum Disorder (ASD) or suspected ASD attended regarding the DAG form was higher compared to the rest of the group (OR 2.25; 95% CI 1.1-4.5; P 0.02). Other reasons for consultations included 22 (10.8%) consulted for Special Educational Needs (SEN) medical reports, 34 (16.6%) attended for prescriptions: 14 (7%) Risperidal and 12 (6%) Methylphenidate and 8 (4%) consulted regarding face masks. 6 (3%) consulted for behavioural problems. Conclusion During COVID-19, community paediatric consultations were predominantly telemedicine and face-to-face without the child. Reasons for consultations included, DAG forms, prescriptions, SEN reports, behavioural problems and letters regarding face masks. Further research regarding the effectiveness of the hybrid telemedicine/face to face system is required.