Trends in US Pediatric Hospital Admissions in 2020 Compared With the Decade Before the COVID-19 Pandemic.
JAMA Netw Open
; 4(2): e2037227, 2021 02 01.
Article
in English
| MEDLINE | ID: covidwho-1083348
ABSTRACT
Importance In early 2020, the United States declared a public health emergency in response to coronavirus disease 2019 (COVID-19) and implemented a variety of social distancing measures. The association between the COVID-19 pandemic and the number of pediatric admissions is unclear. Objective:
To determine the changes in patterns of pediatric admissions in 2020 compared with the prior decade. Design, Setting, andParticipants:
This cross-sectional study included 49 US hospitals contributing to the Pediatric Health Information Systems database. Inpatient admissions were transformed into time-series data, and ensemble forecasting models were generated to analyze admissions across a range of diagnoses in 2020 compared with previous years. The setting was inpatient admissions. All patients discharged between January 1, 2010, and June 30, 2020, from an inpatient hospital encounter were included. Main Outcomes andMeasures:
Number of hospital admissions by primary diagnosis for each encounter.Results:
Of 5â¯424â¯688 inpatient encounters among 3â¯372â¯839 patients (median [interquartile range] age, 5.1 [0.7-13.3] years; 2â¯823â¯748 [52.1%] boys; 3â¯171â¯224 [58.5%] White individuals) at 49 hospitals, 213â¯571 (3.9%) were between January 1, 2020, and June 30, 2020. There was a decrease in the number of admissions beginning in March 2020 compared with the period from 2010 to 2019. At the nadir, admissions in April 2020 were reduced 45.4% compared with prior years (23â¯798 in April 2020 compared with a median [interquartile range] of 43â¯550 [42â¯110-43â¯946] in April 2010-2019). Inflation-adjusted hospital charges decreased 27.7% in the second quarter of 2020 compared with prior years ($4â¯327â¯580â¯511 in 2020 compared with a median [interquartile range] of $5â¯983â¯142â¯102 [$5â¯762â¯690â¯022-$6â¯324â¯978â¯456] in 2010-2019). Seasonal patterns were evident between 2010 and 2019 for a variety of common pediatric conditions, including asthma, atrial septal defects, bronchiolitis, diabetic ketoacidosis, Kawasaki syndrome, mental health admissions, and trauma. Ensemble models were able to discern seasonal patterns in admission diagnoses and accurately predicted admission rates from July 2019 until December 2019 but not from January 2020 to June 2020. All diagnoses except for birth decreased below the model 95% CIs between January 2020 and June 2020. Conclusions and Relevance In this cross-sectional study, pediatric admissions to US hospitals decreased in 2020 across an array of pediatric conditions. Although some conditions may have decreased in incidence, others may represent unmet needs in pediatric care during the COVID-19 pandemic.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Seasons
/
Pandemics
/
COVID-19
/
Hospitalization
/
Hospitals, Pediatric
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
North America
Language:
English
Journal:
JAMA Netw Open
Year:
2021
Document Type:
Article
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