Early unplanned return visits to pediatric emergency departments in Israel during the SARS-CoV-2 pandemic

https://doi.org/10.1016/j.ajem.2023.03.021Get rights and content

Abstract

Introduction

During the SARS-CoV-2 pandemic there was a considerable drop in the number of visits to Pediatric Emergency Departments (PED). Unplanned return visits (URV) might represent inadequate emergency care. We assessed the impact of the pandemic on early URV to PEDs in Israel.

Methods

This multicenter cross-sectional study analyzed the 72-h URV to PEDs among patients under the age of 18 years during a one-year pandemic period (March 1st, 2020, to February 28th, 2021), and compared them with the 72-h URV of the corresponding pre-pandemic period (March 1st, 2019, to February 28th, 2020). Data was extracted from Clalit Health Services (CHS), the largest public health care organization in Israel.

Results

The pandemic and pre-pandemic early URV rates were 5465 (5.1%) and 8775 (5.6%), respectively (OR = 0.90, 95% CI 0.92–0.99). The rate of return-visit admissions to hospital wards during these periods were 29.5% and 32.1%, respectively (OR = 0.83, 95% CI 0.86–0.98). The rate of return-visit admissions to ICUs during these periods were 0.64% and 0.52%, respectively (OR = 1.11, 95% CI 0.67–1.62). On return-visit, 3 (0.055%) and 5 (0.057%) URV patients were declared dead on arrival during the pandemic and pre-pandemic periods, respectively (OR = 0.96, 95% CI 0.23–4.03). The distributions of the time interval from index visit to return visit remained consistent between the periods.

Discussion

In our study, early URV to PED's were only mildly influenced by the SARS-CoV-2 pandemic.

Keywords

Pediatrics
Unplanned return visits
SARS-CoV-2
Emergency medicine

Abbreviations

ED
Emergency Department
ICU
Intensive Care Unit
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
URV
unplanned return visit

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1

Dr. Abu Hanna and Dr. Shavit contributed equally.

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