661 Identifying children ‘missing’ during UK COVID-19 lockdown: A retrospective cohort study (2015–2020) of Oxfordshire ED attendances and inpatient diagnoses

• Published in: Archives of disease in childhood 2021-10, Vol.106 (Suppl 1), p.A74-A74
• Main Authors: Charlesworth, James EG, Bold, Rhian, Pal, Rani
• Format: Article
• Language: English
• Subjects: Abstracts; Children; Coding; Complications; Coronaviruses; COVID-19; Disease; Health care; Hospitals; Infectious diseases; Medical diagnosis; Medical personnel; Morbidity; Pandemics; Patients; Pediatrics; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2021-rcpch.127

BackgroundOn 23rd March 2020, the UK ‘stay at home’ order heralded the first national lockdown, lasting 7-weeks. Dramatic reductions of paediatric attendances/admissions were noted nationally and internationally, with concerns surrounding diagnosis which may be missing from secondary care.We conducted a systematic review on 9th January 2021, searching PubMed for ‘COVID’, AND ‘lockdown’, AND ‘paediatric’ OR ‘children’, AND ‘attendance’ OR ‘admission’, in all languages using MESH terms. This identified n=41 primary articles exploring paediatric healthcare usage during a lockdown period. These covered Europe, Brazil, USA, Canada, Iran, and India. 44% examined ED settings only; 49% reported on admissions for a single disease or specialty; only 2 examined all inpatients.No previous study has explored the changing patterns of diagnoses amongst all paediatric inpatients during a lockdown period, compared to historical years.ObjectivesTo establish the changing patterns of ED attendance and inpatient diagnoses across two Oxfordshire hospitals during the first COVID-19 lockdown in 2020, compared to five historical years (2015–2019).MethodsWe retrospectively reviewed anonymised electronic records for all ED attendances and inpatients aged 0–15 years, across two Oxfordshire hospitals providing secondary and tertiary care services. Discharge ICD-10 coding were analysed to identify significant differences in lockdown inpatient diagnoses, compared to a matched 7-weeks in 2015–2019 (Mann-Whitney U test, admissions-per-week).ResultsDuring the first 2020 lockdown period, 2,843 diagnoses were associated with 1,416 admissions (mean 4.81 diagnoses/patient), compared with 12,458 admissions and 19,946 diagnoses across matched dates 2015–2019 (2.97 diagnoses/patient). Lockdown ED attendances (n=4030) and admissions (n=1416) were reduced by 56.8% and 59.4%, respectively, compared to 2015–2019 (mean n=7446.8 and n=2491.6, respectively). Proportions of admissions from ED and patients’ subsequent length of stay were similar across all years. Reductions in hospital admissions were highest in 1–5-year-old (age