Title

Impact of COVID-19 on Admissions and Outcomes for Children With Complex Chronic Conditions.

Document Type

Article

Publication Date

4-1-2022

Identifier

DOI: 10.1542/hpeds.2021-006334

Abstract

BACKGROUND: Although pediatric health care use declined during the coronavirus disease 2019 (COVID-19) pandemic, the impact on children with complex chronic conditions (CCCs) has not been well reported.

OBJECTIVE: To describe the impact of the pandemic on inpatient use and outcomes for children with CCCs.

METHODS: This multicenter cross-sectional study used data from the Pediatric Health Information System. We examined trends in admissions between January 2020 through March 2021, comparing them to the same timeframe in the previous 3 years (pre-COVID-19). We used generalized linear mixed models to examine the association of the COVID-19 period and outcomes for children with CCCs presenting between March 16, 2020 to March 15, 2021 (COVID-19 period) to the same timeframe in the previous 3 years (pre-COVID-19).

RESULTS: Children with CCCs experienced a 19.5% overall decline in admissions during the COVID-19 pandemic. Declines began in the second week of March of 2020, reaching a nadir in early April 2020. Changes in admissions varied over time and by admission indication. Children with CCCs hospitalized for pneumonia and bronchiolitis experienced overall declines in admissions of 49.7% to 57.7%, whereas children with CCCs hospitalized for diabetes experienced overall increases in admissions of 21.2%. Total and index length of stay, costs, and ICU use, although statistically higher during the COVID-19 period, were similar overall to the pre-COVID-19 period.

CONCLUSIONS: Total admissions for children with CCCs declined nearly 20% during the pandemic. Among prevalent conditions, the greatest declines were observed for children with CCCs hospitalized with respiratory illnesses. Despite declines in admissions, overall hospital-level outcomes remained similar.

Journal Title

Hosp Pediatr

Volume

12

Issue

4

First Page

337

Last Page

353

MeSH Keywords

COVID-19; Child; Chronic Disease; Cross-Sectional Studies; Hospitalization; Humans; Pandemics

Keywords

COVID-19; Child; Chronic Disease; Cross-Sectional Studies; Hospitalization; Humans; Pandemics

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