Study explores pediatric healthcare interruptions amid COVID-19

This study explores the extent to which pediatric health care was interrupted during and as a result of the COVID-19 pandemic. This was measured based on three primary outcomes of interest: foregone care, foregone well-child or vaccination-related visits, and complete absence of well-child or vaccination-related visits. Researchers extracted data from a nationwide longitudinal survey known as CovEx (COVID Experiences Survey) that had been administered in two "waves'' to a cohort of parents of children between five and 12 years of age. Wave 1 took place October 8-November 13, 2020, and Wave 2 took place March 24-May 7, 2021, with an 82% retention rate of participants. Data was examined through the lens of four categories: child-level, parent-level, household-level, and county-level.

Almost one-third (30.1%) of children in the cohort had not had a well-child or vaccination-related visit in over one year, making up the largest percentage among the three primary outcomes of interest. Among the other two measured gaps, 16.3% of children in the cohort had foregone care and 10.9% had foregone well-child or vaccination-related visits. Non-Hispanic White children were at a much lower risk of experiencing any of the three gaps, with the greatest difference seen in their being less than half as likely to have a foregone well-child or vaccination-related visit in comparison to their non-White counterparts. Children who were in school using a completely virtual platform were 1.43 times as likely to forgo care than kids who were in a part-virtual/part-in-person (i.e., hybrid) format or only in-person.

What we know: Health care barriers such as racism and low socioeconomic status continue to disproportionately affect specific populations. The COVID-19 pandemic only compounded these issues, once again affecting the same populations to disproportionate heights and making access to health care even more difficult. 

What this study adds:

This study reiterates how, due to the COVID-19 pandemic, pediatric patients missed routine appointments, with racial disparities increasing this risk. Children in counties with fewer primary care doctors per capita were more likely to miss their well-child or vaccination-related visits. Additionally, children with an existing emotional, mental, or developmental behavioral condition had more than twice the risk of foregone care.