The effect of the COVID‐19 pandemic on pediatric emergency department utilization in three regions in Switzerland

The effect of the COVID‐19 pandemic on pediatric emergency department utilization in three regions in Switzerland

Children, COVID-19, Emergency department, Pandemic, Utilization, Variation

Purpose The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However,
contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization
evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language
regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future
healthcare.
Methods We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st,
2018—February 28th, 2022), analyzing the numbers of ED visits (including patients` age, triage categories, and urgent

vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utiliza-
tion was assessed by interrupted time series (ITS) modelling.

Results Based on 304′438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual
recovery. This primarily affected children 0–4 years, and both non-urgent and urgent cases. However, the decline
in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates
did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory
and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic.

Conclusions The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, par-
ticularly among children 0–4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly

between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pan-
demic. Furthermore, future policy decisions should take regional differences into account.

Keywords Children, COVID-19, Emergency department, Pandemic, Utilization, Variation

Michael von Rhein1* , Aziz Chaouch2

, Vivian Oros3

, Sergio Manzano4

, Gianluca Gualco5

, Marc Sidler6
,

Ursula Laasner7

, Michelle Dey8

, Julia Dratva8,9, Michelle Seiler10 and on behalf of the PedCov consortium

https://doi.org/10.1186/s12245-024-00640-2

2024

Peri Irawan

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