Abstract
We aimed to determine how COVID-19 affected the number and type of pediatric primary care visits in April 2020, compared to April 2019, and which characteristics were associated with obtaining care in 2020. We performed a retrospective chart review of patients receiving care in April 2019 and April 2020 from four large, academic institutions across two states. The subjects were included if they were aged 0–18 years and were seen in a pediatric clinic in April 2019 or April 2020. We extracted the number of visits, visit type, and visit diagnosis; and the patient characteristics, including age, race/ethnicity, and insurance status. Logistic regression analysis identified characteristics associated with obtaining care in April 2020. We included 120,230 visits. Participants were 50% white and half had Medicaid. In 2020 there were significantly fewer visits for both well and acute visits with 42,670 visits in 2020 compared to 77,560 in 2019; 6616 were telehealth visits in 2020. Visits for chronic conditions were significantly decreased in 2020. Attending a visit in 2020 was more likely if the participant was black or Hispanic, younger, attending an acute visit, or had private insurance. During the COVID-19 pandemic, pediatric primary care decreased substantially for both well visits and follow-up of chronic conditions.
Highlights
On 13 March 2020, the World Health Organization declared the SARS-coronavirus-2(SARS-CoV-2) disease 2019 (COVID-19) a global pandemic
The first case of COVID-19 was reported in the United States (U.S.) on 20 January 2020, and the U.S declared a national emergency on 13 March 2020
While there has been growing literature about the impact of the COVID-19 pandemic on pediatric healthcare utilization [8,12,17,18,19,20], there are still limited data on the effect of the pandemic on the volume of pediatric primary care visits and the characteristics of patients who did and did not attend a visit during the pandemic. To fill this gap in the literature, the objective of this study was to determine the association of pediatric primary care delivery and the COVID-19 pandemic
Summary
On 13 March 2020, the World Health Organization declared the SARS-coronavirus-2. (SARS-CoV-2) disease 2019 (COVID-19) a global pandemic. The first case of COVID-19 was reported in the United States (U.S.) on 20 January 2020, and the U.S declared a national emergency on 13 March 2020. As of 19 April 2021, there were over 31 million confirmed cases and over 560,000 deaths due to COVID-19 in the U.S [1]. Infection with SARS-CoV-2 causes less severe disease in children and adolescents compared to adults. Due to the social and economic impact of COVID-19, the pandemic has led to numerous indirect effects in children and adolescents, including missed days of school, worse diet-related behaviors, and increasing rates of anxiety and depression [2,3,4].
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