Race and insurance status played a role in lower pediatric ER visits in 2020 – News

Throughout 2020, the decline in pediatric ER visits among Black and public or self-insured patients was consistently greater than other demographic groups.

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Photography: Bruce Southernland
Visits to pediatric emergency rooms fell sharply in the United States during the first months of the coronavirus pandemic. Findings from a study at the University of Alabama at Birmingham show that relative declines in total emergency department visits, as well as high-acuity visits, were greater among blacks and groups economically disadvantaged, which were also likely to be public or self-insured. This decline could have a significant effect on pediatric public health in the future.

Using data from the Children’s Emergency Department of Alabama, Bisakha Sen, Ph.D., professor and Blue Cross Blue Shield Endowed Chair in the UAB School of Public Health, and Pallavi Ghosh, MD, an assistant professor at UAB and the Division of Pediatric Emergency Medicine for Children, conducted an observational study that focused on the role of racial and economic disparities in the overall decline in emergency room visits in 2020. The results of the peer-reviewed study have been published in the online journal PLOS ONE.

Between 2015 and 2019, the children’s emergency department saw approximately 72,000 pediatric patients per year. There were a combined total of 118,370 visits in 2019 and 2020. The largest drop in visits in 2020 occurred in April and May, with a 70% drop for black and public and self-insured groups and a 60% drop for whites and non-Hispanics. private insured groups. Visits rebounded between June and September before falling again in November. Throughout the year, the decline in the number of black and public or self-insured patients was consistently greater than other study demographics.

“Before the pandemic, African American and economically disadvantaged communities disproportionately used emergency departments because they are often their only option for pediatric health care needs,” Sen said. “Given that the steep declines in these populations included both low and high acuity visits, it is possible that many urgent health care needs were not being met for disadvantaged children.”

Bisakha Sen School of Public Health UABBisakha Sen, Ph.D., Professor and Blue Cross Blue Shield Endowed Chair in the UAB School of Public Health Photography: Steve WoodThe results indicated that unmet essential health care needs likely contributed to worsening pediatric health conditions and disparities between minority and low-income communities. Just as the virus has caused “long-term” health complications in patients, Sen suggests foregoing essential healthcare needs will also have a “long-term” impact on pediatric health and the healthcare system.

“There has already been a drop in routine childhood immunization rates during the pandemic which has led to outbreaks of viruses, like measles, that haven’t happened in years,” Sen said. “Physicians and healthcare systems must prepare for the ripple effect of these pandemic-related healthcare declines. Not only could they realistically see more sick patients in the future, but an increase in the severity of the illnesses of those patients.

Additional studies have shown that disadvantaged groups have borne the financial brunt of the pandemic. Sen suggests that financial disruptions, coupled with reluctance to visit health care organizations to avoid contracting the virus, played a key role in the sharp decline in pediatric ER visits among black people and public and auto demographics. -insured.

“In Alabama, more children have public insurance than private plans, which could add additional pressure on our health care system in the coming years,” said Anne Brisendine, DrPH, assistant professor in the Department of policy and health organization of the UAB and co-author of the study. “Ultimately, all children should receive appropriate and timely health care. The health system and providers must begin to take action now to help minimize the future health consequences of neglecting pediatric emergency care, especially in disadvantaged populations.

The study was funded by the Back of the Envelope Awards initiated by the UAB School of Public Health and the Sparkman Center for Global Health during COVID-19. Read the full study here. The UAB Division of Pediatric Emergency Medicine is part of the Department of Pediatrics at the Marnix E. Heersink School of Medicine.

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