Trends in Pediatric Emergency and Inpatient Healthcare Use for Mental and Behavioral Health Among North Carolinians During the Early COVID-19 Pandemic.
Trends in Pediatric Emergency and Inpatient Healthcare Use for Mental and Behavioral Health Among North Carolinians During the Early COVID-19 Pandemic.
复制标题
COVID-19 大流行早期期间，北卡罗来纳州居民心理和行为健康方面的儿科急诊和住院医疗保健使用趋势。
DOI：
10.1093/jpids/piad092
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发表时间：
2023
影响因子：
3.2
通讯作者：
Brookhart,MAlan
中科院分区：
文献类型：
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作者：
Sielaty,Rachel;Boutzoukas,AngeliqueE;Zimmerman,KaneciaO;Caison,Bria;Charles,CatherineO;CoyneSmith,Taran;Darden,Toni;Overman,RobertA;BenjaminJr,DanielK;Brookhart,MAlan
背景在COVID-19大流行期间，大范围的学校关闭和医疗保健回避导致儿科精神卫生保健服务中断。方法我们对2019年1月至2020年12月期间北卡罗来纳州6-20岁私人保险儿童的紧急和住院行政索赔进行了回顾性研究。我们比较了3个时间段（大流行前、封锁和重新开放）的急诊（艾德）就诊率（每10万人-日）和住院风险（每10万人），以及每个类别（精神/行为健康;自杀意念、自杀企图和故意自残[SI/SA/ISH];和社会问题）的诊断代码。我们计算的比例和95%的置信区间（CI）的总艾德访问和总住院归因于精神/行为健康和SI/SA/ISH在3 timeperiods.ResultsRates的所有类别的艾德访问下降，从大流行前的封锁期;从大流行前的重新开放期间，精神/行为健康的访问减少，但SI/SA/ISH访问率不变。归因于精神/行为健康的艾德就诊比例从3.5%（95% CI 3.2%-3.7%）大流行前至4.0%（95% CI 3.7%-4.3%）重新打开期间，SI/SA/ISH的诊断比例从大流行前的1.6%（95%CI 1.4%-1.8%）增加到重新开放期间的2.4%（95%CI 2.1%-2.7%）。紧急护理使用的社会问题和住院精神/行为健康和SI/SA/ISH诊断在整个研究periods.ConclusionsIn早期流行，儿科心理健康护理和急性自杀危机占急诊护理的比例增加。在大流行恢复期间，了解受影响最严重的人群并增加获得预防性心理卫生保健的机会至关重要。
BackgroundWidespread school closures and health care avoidance during the COVID-19 pandemic led to disruptions in access to pediatric mental health care.MethodsWe conducted a retrospective study of emergency and inpatient administrative claims from privately insured children aged 6–20 years in North Carolina between January 2019 and December 2020. We compared rates of emergency department (ED) visits (per 100 000 person-days) and risks of hospitalizations (per 100 000 persons) with diagnosis codes in each category (mental/behavioral health; suicidal ideation, suicide attempt, and intentional self-harm [SI/SA/ISH]; and social issues) across 3 time periods (pre-pandemic, lockdown, and reopening). We calculated the proportion and 95% confidence intervals (CI) of total ED visits and total hospitalizations attributable to mental/behavioral health and SI/SA/ISH across the 3 time periods.ResultsRates of all categories of ED visits decreased from pre-pandemic to the lockdown period; from pre-pandemic to the reopening period, mental/behavioral health visits decreased but rates of SI/SA/ISH visits were unchanged. The proportion of ED visits attributable to mental/behavioral health increased from 3.5% (95% CI 3.2%–3.7%) pre-pandemic to 4.0% (95% CI 3.7%–4.3%) during reopening, and the proportion of SI/SA/ISH diagnoses increased from 1.6% (95% CI 1.4%–1.8%) pre-pandemic to 2.4% (95% CI 2.1%–2.7%) during the reopening period. Emergency care use for social issues and hospital admissions for mental/behavioral health and SI/SA/ISH diagnoses were unchanged across the study periods.ConclusionsIn the early pandemic, pediatric mental health care and acute suicidal crises accounted for increased proportions of emergency care. During pandemic recovery, understanding the populations most impacted and increasing access to preventative mental health care is critical.