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CUPID COVID-19: emergency department attendance by paediatric patients during COVID-19 - project protocol
Thérèse McDonnell1, Eilish McAuliffe1, Michael Barrett2,3,4
1IRIS Centre, UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
Insights
COVID-19 measures may deter parents from seeking emergency care for children. This study examines paediatric emergency department attendance, parental health-seeking behaviors, and barriers to care access during the pandemic.
Area of Science:
- Public Health
- Pediatric Emergency Medicine
- Health Services Research
Background:
- COVID-19 pandemic mitigation strategies may lead to reduced emergency department (ED) visits for non-COVID-19 related pediatric illnesses.
- Concerns exist regarding delayed or avoided urgent medical interventions for children due to pandemic-related fears.
- Historical data from MERS and SARS outbreaks indicate temporary reductions in hospital attendance, with unknown long-term impacts of the prolonged COVID-19 pandemic on pediatric ED utilization.
Purpose of the Study:
- To evaluate the effect of COVID-19 on pediatric emergency healthcare utilization.
- To understand changes in parental health-seeking behaviors during the pandemic.
- To identify and address barriers preventing children from accessing emergency care.
Main Methods:
- Analysis of administrative data from six Irish emergency care sites (five EDs, one Urgent Care Centre) to track attendance trends.
- Qualitative inquiry with healthcare staff to gather insights on pediatric emergency care experiences during COVID-19.
- Cross-sectional survey of parents to document their experiences, concerns, and decision-making processes regarding accessing pediatric healthcare.
Main Results:
- Data analysis is ongoing to identify temporal trends in pediatric emergency care utilization.
- Qualitative feedback from staff will be integrated to interpret quantitative findings.
- Parental survey results will provide insights into health-seeking behaviors and decision-making.
Conclusions:
- Findings will inform rapid response strategies for pediatric patient needs amidst the evolving pandemic.
- The study aims to minimize disruption to routine pediatric emergency services.
- Timely access to emergency care is critical for children, as their health can deteriorate rapidly, potentially leading to severe consequences if delayed.
Abstract:
Background: Measures introduced to delay the spread of COVID-19 may result in avoidance of emergency departments (EDs) for non-COVID related illness. Clinicians and medical representative bodies such as the Irish Association for Emergency Medicine (IAEM) have expressed concern that some patients may not seek timely urgent medical intervention. Evidence from previous epidemics found that hospital avoidance during outbreaks of MERS and SARS was common. While ED attendance returned to normal following SARS and MERS, both outbreaks lasted 2-3 months. As the COVID-19 pandemic is forecast to extend into 2021, little is known about the impact COVID-19 will have on paediatric attendance at EDs as the pandemic evolves. Aims: This project aims to assess the impact of COVID-19 on paediatric emergency healthcare utilisation, to understand how the health seeking behaviour of parents may have altered due to the pandemic, and to identify how any barriers to accessing care can be removed. Methods: Administrative data records from five EDs across Ireland and one Urgent Care Centre will be analysed to identify temporal trends in attendances for emergency care. Qualitative inquiry will be utilised to capture the experience of staff providing emergency healthcare to paediatric patients during COVID-19, and their feedback on identified trends will inform the interpretation of findings. A cross-sectional survey of parents will capture experiences, concerns and decision-making on accessing healthcare for their children during the pandemic. Results and Conclusion: This information will help decision makers respond rapidly to meet the clinical needs of paediatric patients as the circumstances of the pandemic unfold and reduce the disruption to normal paediatric ED services during the onset of COVID-19. As the health of a child can deteriorate more rapidly than that of an adult, any delay in seeking care for an acutely ill child may have serious consequences.
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