Pediatric Injury Transfer Patterns During the COVID-19 Pandemic: An Interrupted time Series Analysis.

Area of Science:

• Pediatric Trauma Care
• Public Health Emergencies
• Healthcare System Capacity

Background:

• The COVID-19 pandemic prompted recommendations for diverting pediatric patients to specialized centers.
• Understanding the impact on interfacility transfers to Pediatric Trauma Centers (PTCs) is crucial.

Purpose of the Study:

• To analyze changes in interfacility transfers to PTCs during the initial six months of the COVID-19 pandemic.
• To compare pediatric trauma transfer volumes and characteristics between the pandemic period and a historical average.

Main Methods:

• Utilized interrupted time-series analysis on data from 9 PTCs for children injured between 2016 and 2020.
• Compared a 'COVID' cohort (pandemic period) with a historical average (HA) cohort (2016-2019).
• Assessed differences in transfer volume, demographics, injury severity, and outcomes.

Main Results:

• A significant increase in transferred patients to PTCs was observed during the COVID-19 cohort compared to the HA cohort (65.4% vs 55.7%).
• The COVID cohort showed a decrease in older pediatric patients (15-17 years) and an increase in patients with lower injury severity scores (≤15).
• A higher proportion of patients in the COVID cohort were discharged directly home from the PTC (31.8% vs 21.83%).

Conclusions:

• Interfacility transfers of pediatric trauma patients to Level I PTCs increased during the COVID-19 pandemic.
• The rise in transfers and direct discharges suggests potential impacts on referring emergency department capacity and pediatric trauma triage capabilities.
• Pediatric trauma transfers may serve as an indicator of healthcare system strain during public health crises.