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Pediatric health care use during the COVID-19 pandemic: Lessons learned from the initial 2020 wave
Anju Wagh1, Sharon Pan1, Stephen Gordon1
1Department of Emergency Medicine Columbia University Irving Medical Center New York New York USA.
Insights
Pediatric medical care use shifted during COVID-19 lockdowns. Caregivers faced barriers like fear of infection, but telemedicine adoption increased, with no reported access issues.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic significantly disrupted routine pediatric medical care.
- Understanding caregiver decision-making during public health emergencies is crucial.
Purpose of the Study:
- To assess changes in pediatric medical care utilization during the COVID-19 lockdown in New York City.
- To identify caregiver perceptions and barriers influencing healthcare access during this period.
Main Methods:
- A survey was administered to 290 caregivers who brought children (0-17 years) to a pediatric emergency department in NYC.
- Data collected from June 14 to December 28, 2020, focused on healthcare access during the March 22 to June 8, 2020 lockdown.
Main Results:
- In-person primary care visits dropped from 64% to 9%; telemedicine use surged from 10% to 54%.
- 36% of caregivers perceived increased difficulty accessing care; common barriers included fear of COVID-19 and avoidance advice.
- Despite disruptions, 91% of caregivers accessed medical care for their children.
Conclusions:
- The COVID-19 pandemic necessitated a rapid shift from in-person to virtual pediatric care.
- Identifying barriers to care access can inform strategies for future public health crises.
Objective:
During the height of the coronavirus disease-2019 (COVID-19) pandemic, there was a decline and shift in pediatric medical care use. We aimed to assess changes to pediatric medical use and perceptions/barriers that influenced caregivers' decision-making during the New York State mandated lockdown from March 22 to June 8, 2020, in a population that opted to use the pediatric emergency department (PED) during this period. This study was conducted in New York City (NYC), one of the epicenters at the height of the COVID-19 pandemic.
Methods:
From June 14 to December 28, 2020, a convenience sample of caregivers who brought children 0-17 years to a NYC PED completed a survey.
Results:
Participants in the survey included 290 caregivers: 76% were Hispanic; 91% reported having accessed medical care when their children were ill during the lockdown. In-person primary care visits decreased from 64% before to 9% during lockdown; 28% missed well-child checkups or vaccinations, and 26% missed specialist appointments. Telemedicine usage increased from 10% to 54%; none reported lack of internet or electronic devices as barriers to using telemedicine. Regarding access to care: 36% perceived increased difficulty during the lockdown, whereas 56% felt no difference. Barriers included fear of contracting COVID-19 and government advice to avoid health care visits for minor problems.
Conclusion:
During the initial wave of the COVID-19 pandemic, medical care shifted from an in-person to a virtual platform. Identification of factors and barriers surrounding caregivers' decision-making may positively inform strategies toward future public health emergencies.
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