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Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic.

Publication ,  Journal Article
Markham, JL; Richardson, T; DePorre, A; Teufel, RJ; Hersh, AL; Fleegler, EW; Antiel, RM; Williams, DC; Goldin, AB; Shah, SS
Published in: Pediatrics
June 2021

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has led to changes in health care use, including decreased emergency department visits for children. In this study, we sought to describe the impact of the COVID-19 pandemic on inpatient use within children's hospitals. METHODS: We performed a retrospective study using the Pediatric Health Information System. We compared inpatient use and clinical outcomes for children 0 to 18 years of age during the COVID-19 period (March 15 to August 29, 2020) to the same time frame in the previous 3 years (pre-COVID-19 period). Adjusted generalized linear mixed models were used to examine the association of the pandemic period with inpatient use. We assessed trends overall and for a subgroup of 15 medical All Patient Refined Diagnosis Related Groups (APR-DRGs). RESULTS: We identified 424 856 hospitalizations (mean: 141 619 hospitalizations per year) in the pre-COVID-19 period and 91 532 in the COVID-19 period. Compared with the median number of hospitalizations in the pre-COVID-19 period, we observed declines in hospitalizations overall (35.1%), and by APR-DRG (range: 8.5%-81.3%) with asthma (81.3%), bronchiolitis (80.1%), and pneumonia (71.4%) experiencing the greatest declines. Overall readmission rates were lower during the COVID-19 period; however, other outcomes, including length of stay, cost, ICU use, and mortality remained similar to the pre-COVID-19 period with some variability by APR-DRGs. CONCLUSIONS: US children's hospitals observed substantial reductions in inpatient admissions with largely unchanged hospital-level outcomes during the COVID-19 pandemic. Although the impact on use varied by condition, the most notable declines were related to inpatient admissions for respiratory conditions, including asthma, bronchiolitis, and pneumonia.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

June 2021

Volume

147

Issue

6

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Pediatrics
  • Patient Acceptance of Health Care
  • Pandemics
  • Male
  • Linear Models
  • Infant, Newborn
  • Infant
  • Humans
 

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APA
Chicago
ICMJE
MLA
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Markham, J. L., Richardson, T., DePorre, A., Teufel, R. J., Hersh, A. L., Fleegler, E. W., … Shah, S. S. (2021). Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic. Pediatrics, 147(6). https://doi.org/10.1542/peds.2020-044735
Markham, Jessica L., Troy Richardson, Adrienne DePorre, Ronald J. Teufel, Adam L. Hersh, Eric W. Fleegler, Ryan M. Antiel, Daniel C. Williams, Adam B. Goldin, and Samir S. Shah. “Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic.Pediatrics 147, no. 6 (June 2021). https://doi.org/10.1542/peds.2020-044735.
Markham JL, Richardson T, DePorre A, Teufel RJ, Hersh AL, Fleegler EW, et al. Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic. Pediatrics. 2021 Jun;147(6).
Markham, Jessica L., et al. “Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic.Pediatrics, vol. 147, no. 6, June 2021. Pubmed, doi:10.1542/peds.2020-044735.
Markham JL, Richardson T, DePorre A, Teufel RJ, Hersh AL, Fleegler EW, Antiel RM, Williams DC, Goldin AB, Shah SS. Inpatient Use and Outcomes at Children's Hospitals During the Early COVID-19 Pandemic. Pediatrics. 2021 Jun;147(6).

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

June 2021

Volume

147

Issue

6

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Pediatrics
  • Patient Acceptance of Health Care
  • Pandemics
  • Male
  • Linear Models
  • Infant, Newborn
  • Infant
  • Humans