Impact of early COVID-19 pandemic events in Singapore on clinic attendance and default rates in a hospital-based ambulatory paediatrics service

Abstract

Background While the impact of COVID-19 on health care seeking behaviour has been well documented in adult studies, little is known about the impact of COVID-19 on ambulatory paediatric care in South East Asia. Objective To analyse the impact of early COVID-19 events on weekly clinic attendance volumes and default rates in the ambulatory paediatric service of a large tertiary teaching hospital in Singapore. Methods We used independent t tests to compare the weekly aggregate clinic attendance and default rates of the different time periods of the early COVID-19 pandemic (early COVID-19, movement controls, release of movement controls). Results The total weekly clinic attendance decreased significantly and default rates increased significantly during the early COVID-19 period prior to the implementation of movement controls. During the period of movement controls, the first visit default rate remained significantly increased despite the postponement of all non-essential first visits. Post movement controls, both the first and follow up visits rebounded to pre-COVID 19 levels. The default rate for follow up visits was significantly lower than baseline in the post movement control period. Conclusions Decreased utilization of ambulatory paediatric care in Singapore in a pandemic has implications for future pandemic preparedness including both health care resource allocation and health communication.