Trends in Pediatric Primary Care Visits During the Coronavirus Disease of 2019 Pandemic.
Trends in Pediatric Primary Care Visits During the Coronavirus Disease of 2019 Pandemic.
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DOI：
10.1016/j.acap.2021.04.031
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发表时间：
2021-11
影响因子：
3.1
通讯作者：
Ray KN
中科院分区：
文献类型：
--
作者：
Schweiberger K;Patel SY;Mehrotra A;Ray KN
在宣布2019年冠状病毒病（COVID-19）为国家紧急状态几个月后，由于不清楚的原因，儿童的访问仍然受到抑制，我们试图通过检查儿童访问率来理解这一点。使用大型商业索赔数据库OptumLabs®数据仓库中18岁以下儿童的去识别索赔数据，我们比较了2020年1月至10月与2018年1月至10月和2019年的每月初级保健就诊和疫苗接接率。使用一系列儿童水平泊松回归模型，根据就诊原因和COVID-19突发公共卫生事件宣布后的第一个月（例如第1个月）对就诊率进行分析。2018年、2019年和2020年的队列分别有340万、340万和310万儿童。与前几年同期相比，2020年第1个月的初级保健就诊减少60%（发病率比[IRR] 0.40, 99%可信区间[CI] 0.40 - 0.40），第7个月的初级保健就诊减少17% （IRR 0.83, 99% CI 0.83 - 0.83）。预防访视率在第1个月下降53% (IRR 0.47, 99% CI 0.47 - 0.47)，但在第7个月比前一年上升8% （IRR 1.08, 99% CI 1.08 - 1.08）。每月的疫苗接种率也遵循类似的模式。在第7个月，以问题为中心的就诊次数减少了31% (IRR 0.69, 99% CI 0.68-0.69)，感染相关的就诊次数明显减少（急性呼吸道感染IRR 0.37, 99% CI 0.36-0.37；肠胃炎IRR 0.20, 99% CI 0.20 - 0.20）。在宣布COVID-19紧急情况七个月后，由于以问题为重点的就诊减少，特别是与感染有关的就诊减少，儿科护理的接收仍然受到抑制。到2020年10月，预防性就诊和疫苗接种率超过了前几年。
Months after the declaration of the coronavirus disease of 2019 (COVID-19) national emergency, visits among children remained suppressed for unclear reasons, which we sought to understand by examining child visit rates. Using de-identified claims data for children <18 years old from OptumLabs® Data Warehouse, a large commercial claims database, we compared monthly primary care visit and vaccination rates from January–October 2020 to January–October 2018 and 2019. Visit rates were analyzed by visit reason and by the month after (eg, month +1) the COVID-19 public health emergency declaration using a series of child-level Poisson regression models. There were 3.4, 3.4, and 3.1 million children in 2018, 2019, and 2020 cohorts, respectively. Compared to the same months in prior years, primary care visits in 2020 were 60% lower in month +1 (incidence rate ratio [IRR] 0.40, 99% confidence interval [CI] 0.40–0.40) and 17% lower in month +7 (IRR 0.83, 99% CI 0.83–0.83). Preventive visit rates were 53% lower in month +1 (IRR 0.47, 99% CI 0.47–0.47), but 8% higher than prior years in month +7 (IRR 1.08, 99% CI 1.08–1.08). Monthly rates of vaccine administration followed a similar pattern. Problem-focused visits remained 31% lower in month +7 (IRR 0.69, 99% CI 0.68–0.69), with notably fewer infection-related visits (acute respiratory tract infections IRR 0.37, 99% CI 0.36–0.37; gastroenteritis IRR 0.20, 99% CI 0.20–0.20). Seven months after the COVID-19 emergency declaration, receipt of pediatric care remained suppressed due to fewer problem-focused visits, with notably fewer infection-related visits. By October 2020, rates of preventive visits and vaccination exceeded rates in prior years.
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影响因子：
2.4
作者：
Jagai JS;Smith GS;Schmid JE;Wade TJ
通讯作者：
Wade TJ
影响因子：
8
作者：
Patrick, Stephen W.;Henkhaus, Laura E.;Davis, Matthew M.
通讯作者：
Davis, Matthew M.
影响因子：
11.8
作者：
Feldman, Amy G.;O'Leary, Sean T.;Danziger-Isakov, Lara
通讯作者：
Danziger-Isakov, Lara
影响因子：
4.6
作者：
Akmatov MK;Steffen A;Holstiege J;Hering R;Schulz M;Bätzing J
通讯作者：
Bätzing J
DOI：
10.15585/mmwr.mm6945a3
发表时间：
2020-11-13
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Leeb RT;Bitsko RH;Radhakrishnan L;Martinez P;Njai R;Holland KM
通讯作者：
Holland KM