Volume 5, Issue 3, 2024
Original Research
- Factors Associated with Pediatric Emergency Department Avoidance During COVID-19 Pandemic: A Cross-sectional, Telephone-based Survey in Beirut, Lebanon
Introduction: We aimed to explore avoidant behavior of parents of frequent pediatric Emergency Department (ED) users, reasons behind avoidance and healthcare seeking behaviors in avoiders during COVID-19 pandemic.
Methods: We conducted a cross-sectional telephone-based survey on parents of frequent pediatric ED users at a tertiary care center in Beirut between March and August 2021.
Results: A total of 240 frequent pediatric ED users were included. Female comprised 39.6% of the sample. Of the surveyed patients, 117 reported ED avoidance. ED avoidance was common among parents of patients with concern for their child contracting COVID-19 during an ED visit (aOR=1.28, p<0.001,95%CI[1.13, 1.45]). However, parents of patients with an underlying malignancy/hematologic disease were less likely to refrain from ED visits (aOR=0.29, p<0.001, 95%CI[0.14, 0.60]). Moreover, 97.9% of parents of patients with acute symptoms who avoided the ED reported the fear of contracting COVID-19 as the main reason behind their avoidance. Of those who had acute symptoms and avoided the ED, the majority messaged or called a doctor as an alternative for their acute complaint. Furthermore, 28.9 sought yielded worse quality of care than what they would have experienced from the ED.
Conclusion: In patients with high ED utilization rates, ED avoidance was common among parents of patients with concern for their child contracting COVID-19 during an ED visit. However, parents of patients with an underlying malignancy/hematologic disease were less likely to report avoidance. Developing alternative strategies to reduce emergency department (ED) avoidance during pandemics is crucial to ensuring that children continue to have access to acute care without a reduction in quality during public health crises.