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Open AccessArticle

Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance

1
Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, D04 C7X2 Dublin, Ireland
2
Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland
3
Women’s and Children’s Health, School of Medicine, University College Dublin, D04 C7X2 Dublin, Ireland
4
National Children’s Research Centre, D12 N512 Dublin, Ireland
5
REDSPOT (Retrieval, Emergency and Disaster Medicine Research and Development), Emergency Department, Limerick University Hospital, V94 F858 Limerick, Ireland
6
Children’s Health Ireland at Temple Street, D01 XD99 Dublin, Ireland
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6719; https://doi.org/10.3390/ijerph17186719
Received: 10 August 2020 / Revised: 3 September 2020 / Accepted: 10 September 2020 / Published: 15 September 2020
(This article belongs to the Section Children's Health)
This study outlines the impact of COVID-19 on paediatric emergency department (ED) utilisation and assesses the extent of healthcare avoidance during each stage of the public health response strategy. Records from five EDs and one urgent care centre in Ireland, representing approximately 48% of national annual public paediatric ED attendances, are analysed to determine changes in characteristics of attendance during the three month period following the first reported COVID-19 case in Ireland, with reference to specific national public health stages. ED attendance reduced by 27–62% across all categories of diagnosis in the Delay phase and remained significantly below prior year levels as the country began Phase One of Reopening, with an incident rate ratio (IRR) of 0.58. The decrease was predominantly attributable to reduced attendance for injury and viral/viral induced conditions resulting from changed living conditions imposed by the public health response. However, attendance for complex chronic conditions also reduced and had yet to return to pre-COVID levels as reopening began. Attendances referred by general practitioners (GPs) dropped by 13 percentage points in the Delay phase and remained at that level. While changes in living conditions explain much of the decrease in overall attendance and in GP referrals, reduced attendance for complex chronic conditions may indicate avoidance behaviour and continued surveillance is necessary. View Full-Text
Keywords: COVID-19; paediatric; public health; emergency medicine; delayed attendance; avoidance COVID-19; paediatric; public health; emergency medicine; delayed attendance; avoidance
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MDPI and ACS Style

McDonnell, T.; Nicholson, E.; Conlon, C.; Barrett, M.; Cummins, F.; Hensey, C.; McAuliffe, E. Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance. Int. J. Environ. Res. Public Health 2020, 17, 6719.

AMA Style

McDonnell T, Nicholson E, Conlon C, Barrett M, Cummins F, Hensey C, McAuliffe E. Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance. International Journal of Environmental Research and Public Health. 2020; 17(18):6719.

Chicago/Turabian Style

McDonnell, Thérèse; Nicholson, Emma; Conlon, Ciara; Barrett, Michael; Cummins, Fergal; Hensey, Conor; McAuliffe, Eilish. 2020. "Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance" Int. J. Environ. Res. Public Health 17, no. 18: 6719.

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