Evidence map›Paper›PMID 34074712›Full record

ArticleHospital pediatrics2021

Pandemic-Related Shifts in New Patients Admitted to Children's Hospitals.

Nicholas A Clark, Jonathan Rodean, Marcos Mestre, Hemalatha G Rangarajan, Margaret Samuels-Kalow, Prakash Satwani, Joseph R Stanek, Ian D Wolfe, Kenneth A Michelson

Abstract read
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Article in Hospital pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Nicholas A ClarkDivision of Hospital Medicine, Children's Mercy Kansas City, Kansas City, Missouri nclark1@cmh.edu.
Jonathan RodeanChildren's Hospital Association, Lenexa, Kansas.
Marcos MestreDivision of Hospital Medicine, Department of Pediatrics, Nicklaus Children's Hospital, Miami, Florida.
Hemalatha G RangarajanDivision of Hematology, Oncology, and Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio.
Margaret Samuels-KalowDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Prakash SatwaniDepartment of Pediatrics, Columbia University Irving Medical Center, New York, New York.
Joseph R StanekDivision of Hematology, Oncology, and Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio.
Ian D WolfeClinical Ethics Department, Children's Minnesota, Minneapolis, Minnesota.
Kenneth A MichelsonDivision of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.

Funding

Delayed Diagnosis of Serious Pediatric Emergency ConditionsK08HS026503 · AHRQ · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI MICHELSON, KENNETH · 2019 to 2023
$763k
6 · The paper itself

Abstract

objectivesDuring the coronavirus disease 2019 pandemic, professional organizations recommended preferential transfer of pediatric patients from general hospitals to children's hospitals. Patients previously receiving all care at other facilities would be new to children's hospitals. As a proxy for care consolidation, we sought to describe changes in new patient encounters at children's hospitals and test associations between local severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidences and new patient encounters.

methodsThis retrospective cohort study included patients aged 6 months to 18 years admitted to children's hospitals from March 15, 2019, to June 30, 2019 (control) and 2020 (pandemic period). Primary outcome was odds ratio of being a new versus established patient by study period. Generalized linear models estimated odds of being a new patient with adjustment for diagnosis. Analyses were also stratified by local SARS-CoV-2 transmission.

resultsThere were 205 283 encounters (45.3% new patients). New patients were more common in the pandemic period than in the control (46.4 vs 44.7%, OR 1.07, 95% confidence interval [CI]: 1.05 to 1.09). After adjusting for diagnosis, pandemic new patients were no more common than control new patients (adjusted odds ratio 1.00, 95% CI: 0.98 to 1.02). Compared with hospitals experiencing low local SARS-CoV-2 transmission, admission encounters at both medium and high transmission hospitals were more likely to be new (adjusted odds ratio 1.08, 95% CI: 1.03 to 1.14 and 1.09, 95% CI: 1.03 to 1.15, respectively).

conclusionsDuring the early coronavirus disease 2019 pandemic, proportional increases in new patients to children's hospitals appeared to be due to changes in diagnoses but were also associated with local SARS-CoV-2 transmission. Pediatric care consolidation may have occurred; how this may have impacted outcomes for hospitalized children is unclear.

Indexed as

COVID-19PandemicsAdolescentChildChild, PreschoolHospitals, PediatricHumansInfantRetrospective StudiesSARS-CoV-2

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.