从2017年到2022年,儿童心理健康急诊室的访问:一个多中心研究
Jennifer A Hoffmann1, Camille P Carter2, Cody S Olsen2
1Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
概括
在COVID-19大流行期间,儿科心理健康 (MH) 紧急部门 (ED) 的访问总体下降. 然而,针对特定疾病和女性的访问仍然很高,这凸显了有针对性的MH护理的需要.
科学领域:
- 儿科急救医学 儿科急救医学
- 儿童和青少年精神病学 儿童和青少年精神病学
- 公共卫生 公共卫生
背景情况:
- COVID-19大流行严重影响了儿童的心理健康 (MH).
- 在疫情期间,儿童使用MH急诊室 (ED) 的模式发生了变化.
- 儿科MH ED访问的流行前趋势为比较提供了基线.
研究的目的:
- 评估COVID-19大流行期间儿科MHED访问与预期的流行前趋势有何不同.
- 为了分析儿科MHED访问持续时间的变化.
- 为了确定与改变MH ED利用相关的人口和临床因素.
主要方法:
- 从2017年到2022年,对儿科MH ED访问 (年龄在5岁至<18岁) 的回顾性研究.
- 利用了来自美国9家医院的数据,在儿科紧急护理应用研究网络注册表中.
- 采用多变量波桑回归来估计预期访问率和观察到与预期访问的计算率比率 (RRs).
主要成果:
- 总共有175,979个儿科MH ED访问被确定.
- 超过12小时的访问时间从大流行前 (7.3%) 到大流行后期 (19.2%) 显著增加.
- 总体而言,儿科MH ED访问在流行病早期 (RR 0.80) 和晚期 (RR 0.92) 减少,但在流行病中期 (RR 1.01) 类似.
- 女性 (RR 1.10) 和双相情感障碍 (RR 1.83),精神分裂症谱 (RR 1.55) 和与物质有关的疾病 (RR 1.50) 的晚期大流行病访问量高于预期.
结论:
- 在大流行后期,儿科MHED访问量下降到低于预期的水平.
- 妇女的访问率增加和特定疾病表明需要有针对性的干预措施.
- 增加ED访问长度可能表明门诊MH服务的可用性不足.
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