Disruption of paediatric orthopaedic hospital services due to the COVID-19 pandemic in a region with minimal COVID-19 illness

Wong, F. L., Antoniou, G., Williams, N. and Cundy, P. J. (2020) Disruption of paediatric orthopaedic hospital services due to the COVID-19 pandemic in a region with minimal COVID-19 illness. Journal of Children's Orthopaedics, 14(4), pp. 245-251. (doi: 10.1302/1863-2548.14.200140) (PMID:32874355) (PMCID:PMC7453176)

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Purpose: This study was designed to evaluate the impact of the COVID-19 pandemic on paediatric orthopaedic services in a paediatric tertiary hospital in South Australia. Methods: A retrospective audit was conducted of orthopaedic activity at a major paediatric tertiary hospital with a Level 1 paediatric trauma centre, where no patients were admitted with COVID-19 illness. Orthopaedic Emergency Department (ED) presentations, outpatient clinics and hospital admissions for the period between 16 March 2020 to 26 April 2020 were studied and compared with the same period in 2019 (18 March 2019 to 28 April 2019). Chi-square tests were performed with p < 0.05 indicating statistical significance. Results: In total, 621 patients presented to the ED with orthopaedic complaints during the pandemic (versus 997 in 2019). However, there was minimal change in the number of ED presentations requiring admission (110 in 2020 versus 116 in 2019). Among patients discharged directly from ED, 27.3% received hospital outpatient referral (versus 39.1% in 2019), with the remaining patients referred to community health services or discharged directly. There was a 509.8% increase in telehealth (video and phone) outpatient consultations compared to 2019 and a 60.6% decline in face-to-face appointments. There was a total of 144 orthopaedic admissions (elective and emergency) compared to 184 in 2019. Admissions for children under seven remained unchanged (32.5% reduction in children aged seven and above). Conclusion: Despite an overall decline in all paediatric orthopaedic hospital activity, the number of emergency admissions for musculoskeletal conditions did not change. Elective surgery numbers for children aged under seven were also unchanged. Appropriate planning and hospital resources allocation are necessary to meet this service requirement in future pandemics. Level of evidence IV

Item Type:Articles
Keywords:Paediatric, COVID-19, hospital services, trauma, outpatient, pandemic.
Glasgow Author(s) Enlighten ID:UNSPECIFIED
Authors: Wong, F. L., Antoniou, G., Williams, N., and Cundy, P. J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Children's Orthopaedics
Publisher:British Editorial Society of Bone and Joint Surgery
ISSN (Online):1863-2548
Published Online:24 July 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Journal of Children's Orthopaedics 14(4): 245-251
Publisher Policy:Reproduced under a Creative Commons License

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