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Impact of COVID-19 pandemic on emergency department attendances for young people
  1. Folasade Solanke1,
  2. Stephanie Easton1,2,
  3. Anna Selby1,2,
  4. David James2,
  5. Graham Roberts1,2,3,4
  1. 1Faculty of Medicine, University of Southampton, Southampton, UK
  2. 2Department of Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  3. 3David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, UK
  4. 4NIHR Southampton Biomedical Research Centre, University Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Professor Graham Roberts, University of Southampton Faculty of Medicine, Southampton, UK; g.c.roberts{at}soton.ac.uk

Abstract

Introduction There are concerns that the COVID-19 pandemic is having an indirect negative impact on young people. We aimed to assess the impact of the pandemic on emergency department (ED) presentations and admissions.

Design We analysed ED presentations and admissions from a 5-year period (April 2016–February 2021). An interrupted time series analysis was used to estimate the presentations and admissions that would have been seen in year 5 without the pandemic using the data from years 1 to 4. These estimations were used to calculate the difference between the expected and the observed presentations and admissions during the pandemic year.

Results There were 166 459 presentations over 5 years. There was a 38.1% (95% CI 33.9% to 42.3%) reduction in presentations during the pandemic with no variation by sex, age, deprivation or ethnicity. Largest reductions were associated with children being home schooled rather than with lockdowns. For admissions, there was a 23.4% (17.4% to 29.4%) reduction, less for 5–17 year age group. Infection and asthma/wheeze presentations reduced by around 60% with smaller reductions for mental health and trauma. There was no change for surgical presentations, burns/scolds or allergic reactions. There was an increase in females aged 11–17 years presenting with mental health issues during the pandemic.

Conclusions During the pandemic, there was a substantial reduction in both ED presentations and admissions. The differential impact on specific presentations suggests this was due to the impact of social distancing and reduced social mixing rather than widening of health inequality or increased barriers to care.

Trial registration number NCT04893122.

  • Covid-19
  • Child Health
  • Adolescent Health
  • Emergency Care

Data availability statement

No data are available. Data are not available for sharing due to lack of ethical permission.

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Data availability statement

No data are available. Data are not available for sharing due to lack of ethical permission.

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Footnotes

  • Correction notice This article has been corrected since it was first published. Table 2 has been updated so that it reflects what was originally submitted by the authors.

  • Contributors FS and GR conceived the study and developed the protocol with the help of the other authors. DJ provided the data. FS, AS and GR analysed the data. All the authors contributed for to the interpretation of the analysis and drafting and revising the manuscript. All authors approved of the final version of the manuscript and agree to be accountable for the work. GR acts as guarantor for the paper and accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding This work was supported by The University of Southampton Faculty of Medicine. GR is supported by the National Institute of Health Research Southampton Biomedical Research Centre.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.