마스크 착용 의무 해제 이후 응급실 소아 환자의 방문 양상 변화 분석
Change of utilization of emergency department in children after lifting mask mandates in a single center in Korea
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Purpose: We aimed to investigate changes in visiting patterns after the lifting of mask mandates in a single pediatric emergency medical center in Seoul, Korea. Methods: This retrospective study was based on the data of patients’ (≤ 18 years) visits to the emergency department (ED) of the center from January 1, 2022 through June 30, 2023. Clinical characteristics, Korean Triage and Acuity Scale (KTAS) level, ED outcomes, and length of stay were compared between before (March 20-June 30, 2022) and after (March 20-June 30, 2023) the lifting of mask mandates. The comparisons were iterated in the patients with infectious disease. Results: During the study period, a total of 18,654 children visited the ED. After the lifting of mask mandates, ED visits increased from 7,146 to 11,508 (61.0%; 95% confidence interval, 59.5-62.6; P < 0.001). The increase was more prominent in the age of 2-5 years (82.9%), infectious diseases (175.3%), KTAS level 3 (127.7%), and length of stay shorter than 3 hours (78.8%-92.6%). The number of patients per hour increased by 151.2% for 5 patients or more and over 3,000% for 10 or more. Median length of stay decreased (2.3 hours [interquartile range, 1.2-4.1] to 1.9 hours [1.1-3.5]; P < 0.001). The patients with infectious disease (n = 7,139) showed similar patterns of increase in the age of 2-5 years, KTAS level 3, and length of stay shorter than 3 hours, with an additional increase in the age of 6-18 years. Conclusion: After the lifting of mask mandates, pediatric visits increased by 61%, with the highest increase in children with mild infectious diseases on weekends and at night, and the proportion of more than 10 visits per hour significantly increased. We need urgent and realistic support measures from health authorities.
Abstract
Purpose: We aimed to investigate changes in visiting patterns after the lifting of mask mandates in a single pediatric emergency medical center in Seoul, Korea. Methods: This retrospective study was based on the data of patients’ (≤ 18 years) visits to the emergency department (ED) of the center from January 1, 2022 through June 30, 2023. Clinical characteristics, Korean Triage and Acuity Scale (KTAS) level, ED outcomes, and length of stay were compared between before (March 20-June 30, 2022) and after (March 20-June 30, 2023) the lifting of mask mandates. The comparisons were iterated in the patients with infectious disease. Results: During the study period, a total of 18,654 children visited the ED. After the lifting of mask mandates, ED visits increased from 7,146 to 11,508 (61.0%; 95% confidence interval, 59.5-62.6; P < 0.001). The increase was more prominent in the age of 2-5 years (82.9%), infectious diseases (175.3%), KTAS level 3 (127.7%), and length of stay shorter than 3 hours (78.8%-92.6%). The number of patients per hour increased by 151.2% for 5 patients or more and over 3,000% for 10 or more. Median length of stay decreased (2.3 hours [interquartile range, 1.2-4.1] to 1.9 hours [1.1-3.5]; P < 0.001). The patients with infectious disease (n = 7,139) showed similar patterns of increase in the age of 2-5 years, KTAS level 3, and length of stay shorter than 3 hours, with an additional increase in the age of 6-18 years. Conclusion: After the lifting of mask mandates, pediatric visits increased by 61%, with the highest increase in children with mild infectious diseases on weekends and at night, and the proportion of more than 10 visits per hour significantly increased. We need urgent and realistic support measures from health authorities.
참고문헌 (20)
- Chaiyachati BH, "Trends in pediatric emergency department utilization after institution of coronavirus disease19 mandatory social distancing", J Pediatr, 226, pp.274~277 (2020)
- Jang KM, "Pediatric emergency department utilization and coronavirus disease in Daegu, Korea", J Korean Med Sci, 36, pp.e11~ (2021)
- Choi DH, "Impact of the COVID-19 outbreak on trends in emergency department utilization in children : a multicenter retrospective observational study in Seoul Metropolitan Area, Korea", J Korean Med Sci, 36, pp.e44~ (2021)
- "Mask wearing to become mandatory" (2023)[URL]
- "Social distancing restrictions to be lifted starting April 18" (2023)[URL]
- "From March 20 (Monday), the obligation to wear indoor masks on public transportation will be lifted" (2023)[URL]
- "Pediatric specialized emergency medical center, “zero realism”" (2015)[URL]
- "Press release on the crisis in the healthcare system due to a shortage of pediatricians and primary care physicians" (2022)[URL]
- Williams K, "Standard 6 : age groups for pediatric trials", Pediatrics, 129(Suppl 3), pp.S153~S160 (2012)
- Lim T, "Pediatric Korean Triage and Acuity Scale", Pediatr Emerg Med J, 2, pp.53~58 (2015)
- Kang DH, "Coronavirus disease 2019 pandemic-related change in children’s visits to the emergency department", Pediatr Emerg Med J, 9, pp.29~34 (2022)
- Lee SJ, "Changes in clinical characteristics among febrile patients visiting the emergency department before and after the COVID-19 outbreak", Yonsei Med J, 62, pp.1136~1144 (2021)
- Hwang SY, "Long-term impact of coronavirus disease 2019 pandemic on emergency department utilization in a metropolitan emergency department in Korea", Pediatr Emerg Med J, 8, pp.57~65 (2021)
- Comelli I, "Impact of the COVID-19 epidemic on census, organization and activity of a large urban emergency department", Acta Biomed, 91, pp.45~49 (2020)
- Paek SH, "The impact of Middle East respiratory syndrome outbreak on trends in emergency department utilization patterns", J Korean Med Sci, 32, pp.1576~1580 (2017)
- Jang WM, "Social distancing and transmission-reducing practices during the 2019 coronavirus disease and 2015 Middle East respiratory syndrome coronavirus outbreaks in Korea", J Korean Med Sci, 35, pp.e220~ (2020)
- Hartnett KP, "Impact of the COVID-19 pandemic on emergency department visits-United States, January 1, 2019-May 30, 2020", MMWR Morb Mortal Wkly Rep, 69, pp.699~704 (2020)
- Kim HB, "Epidemiology of traumatic head injury in Korean children", J Korean Med Sci, 27, pp.437~442 (2012)
- "Pediatric specialized emergency centers, disqualified due to not meeting the designation criteria, with about half losing their qualifications" (2020)[URL]
- "The pediatric residency program has a capacity of 208 positions, but there are only one-fourth of the applicants" (2023)[URL]
