Changes in paediatric Ambulatory Care Sensitive Conditions in Victoria, 2018–20: the COVID-19 effect?
Mary White A B C * , Simon Craig D E , Wanyu Chu A and Harriet Hiscock A C FA Health Services Research Unit, The Royal Children’s Hospital, Parkville, Melbourne, Vic., Australia.
B Department of Endocrinology & Diabetes, The Royal Children’s Hospital, Parkville, Melbourne, Vic., Australia.
C Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Vic., Australia.
D Department of Paediatrics, Monash University, Clayton, Vic., Australia.
E Paediatric Emergency Department, Monash Medical Centre, Clayton, Vic., Australia.
F Health Services Group, Murdoch Children’s Research Institute, Parkville, Melbourne, Vic., Australia.
Australian Health Review 47(1) 77-87 https://doi.org/10.1071/AH22050
Submitted: 10 March 2022 Accepted: 21 September 2022 Published: 20 October 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY).
Abstract
Objectives This study sought to describe the patterns in emergency department (ED) presentations and hospital admissions in children with Ambulatory Care Sensitive Conditions (ACSCs) before and during the coronavirus disease 2019 (COVID-19) pandemic restrictions in Victoria, Australia, to assess if changes in out-of-hospital care resulted in an increase in delayed/severe presentations.
Methods This study involved secondary analysis of Victorian Emergency Minimum Dataset and Victorian Admitted Episode Dataset data. Patients (<18 years) attending EDs with a diagnosis of an ACSC were included. We compared the number and severity of ASCS presentations pre-COVID-19 (1January 2018–27 March 2020) and during COVID-19 (28 March–31 October 2020). A linear regression prediction model was built to compare the observed versus predicted presentation number in the 2020 period.
Results In total, there were 108 104 paediatric ACSC ED presentations in Victoria during the study period. Females accounted for 51 462/108 104 (47.6%) of all presentations, with a median age of 3 years. A significant decrease in ED presentations was seen in 2020 (41 319 in 2018; 44 978 in 2019; and 21 807 until October 2020), predominantly due to reductions in conditions that are typically mediated by viruses in childhood (i.e. asthma, convulsions/epilepsy and ear, nose and throat conditions). The proportion of high-urgency presentations and those requiring admission was stable in 2020.
Conclusions An overall reduction in the number of ED presentations and admissions with paediatric ACSCs was seen in Victoria in 2020, indicating that rates of delayed or more severe presentations did not occur as a result of changes in out-of-hospital care.
Keywords: Ambulatory Care Sensitive Conditions, Australia, COVID-19, emergency department, hospital admissions, linked data, paediatric, pandemic, SARS‑CoV‑2, Victoria.
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