Disparities by race and insurance-status in declines in pediatric ED utilization during the COVID19 pandemic

Pediatric Emergency Department (ED) utilization in the U.S. saw large declines during the COVID19 pandemic. What is relatively unexplored is whether the extent of declines differed by race and insurance status. An observational study was conducted using electronic medical record (EMR) data from the...

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Bibliographic Details
Published in:PloS one 2022-02, Vol.17 (2), p.e0262490
Main Authors: Sen, Bisakha Pia, Brisendine, Anne, Yang, Nianlan, Ghosh, Pallavi
Format: Article
Language:English
Subjects:
Adolescent
African Americans
Alabama - epidemiology
Black or African American - statistics & numerical data
Child
Child, Preschool
Computer and Information Sciences
COVID-19
COVID-19 - epidemiology
Electronic health records
Electronic medical records
Emergency medical care
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Evaluation
Female
Health care
Health care disparities
Healthcare Disparities - statistics & numerical data
Hispanic people
Humans
Infant
Insurance
Insurance Coverage - statistics & numerical data
Insurance, Health - statistics & numerical data
Low income groups
Male
Medicaid
Medical care
Medicine and Health Sciences
Pandemics
Pediatric emergencies
Pediatrics
People and places
Public health
Quality management
Race
Subgroups
White - statistics & numerical data
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Summary:Pediatric Emergency Department (ED) utilization in the U.S. saw large declines during the COVID19 pandemic. What is relatively unexplored is whether the extent of declines differed by race and insurance status. An observational study was conducted using electronic medical record (EMR) data from the largest pediatric ED in Alabama for 2020 and 2019. The four subgroups of interest were African-American (AA), Non-Hispanic White (NHW), privately insured (PRIVATE), and publicly insured or self-insured (PUBLIC-SELF). Percentage changes in the 7-day moving average between dates in 2020 and 2019 were computed for total and high-severity ED visits by subgroup. Trends in percentage changes were plotted. T-tests were used to compare mean changes between subgroups. Large percentage declines in total ED visits and somewhat smaller percentage declines in high-severity visits were observed from March 2020. Declines were consistently larger for AA than NHW and for PUBLIC-SELF than PRIVATE. T-test results indicated mean date-specific percentage declines were significantly larger for AA than NHW for total visits (-38.92% [95% CI: -41.1, -36.8] versus -29.11% [95% CI: -30.8, -27.4]; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0262490