Effect of the COVID-19 Pandemic on the Pediatric Emergency Department Flow

Area of Science:

• Pediatric Emergency Medicine
• Public Health
• Infectious Disease Epidemiology

Background:

• The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to healthcare systems globally.
• Early pandemic phases necessitated rapid adaptation of emergency department (ED) operations to manage patient flow and acuity.

Purpose of the Study:

• To analyze the impact of the early COVID-19 pandemic on pediatric emergency department (PED) utilization and patient characteristics.
• To identify changes in chief complaints, patient acuity, and disposition patterns during the initial months of the pandemic.

Main Methods:

• A cross-sectional study design was employed, analyzing data from January to April, 2016-2020.
• Pediatric emergency department visit data included total visits, Emergency Severity Index (ESI), disposition, chief complaint, age, provider-to-disposition time (PTD), and length of stay (PED-LOS).
• Statistical significance was determined using a P-value <0.01.

Main Results:

• A significant decrease in PED visits, ranging from 24-71%, was observed between March and April 2020.
• Chief complaints of fever and cough were most prevalent in March 2020.
• April 2020 saw a shorter mean PED-LOS (123 min vs. 158 min), increased admission rates (14% vs. 8%), a decrease in ESI 4 (10%), and an increase in ESI 3 (8%) (P < 0.001).

Conclusions:

• The early pandemic negatively impacted PED patient flow, characterized by reduced visits and a higher admission rate potentially indicating increased patient acuity.
• Understanding pandemic-related shifts in PED utilization and patient factors is vital for optimizing resource allocation and preparedness for future public health crises.