Impact of COVID-19 Pandemic on the Care of Non-COVID Pediatric Patients: A Healthcare Workers’ Survey from India

Puneet Kaur Sahi, P. Meena, Pallavi, A. Mandal, Aashima Dabas
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Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic-related refocusing of healthcare along with needs for social distancing, complete or partial lockdowns, and burgeoning economic crisis has created immense barriers to the access of healthcare services by the non-COVID patients. Aim: We aimed to assess the perspectives of Indian healthcare workers taking care of pediatric patients on the barriers to healthcare delivery to pediatric non-COVID illnesses. Methods: Indian healthcare workers, working in both public and private sectors, taking care of pediatric patients were surveyed using a predesigned pretested online questionnaire over a period of 1 month (May 2020). The impact on healthcare delivery was graded using a Likert scale. Results: Of the total of 356 responses obtained, 75.3% reported a significant negative impact of the COVID-19 pandemic on delivery of healthcare to non-COVID pediatric patients. Respondents of government and COVID hospitals reported a significantly worse impact than private (P = 0.0002) and non-COVID hospitals (P = 0.01), respectively. Significant decline in number of non-COVID patients attending outpatient department (86.2%), admitted in wards (71.6%), number of routine (81.7%) and emergency surgeries (60.5%), number of diagnostic procedures (61.2%), and scheduled therapies (50.2%) was reported by the surveyed healthcare workers. Most important factors for disrupted healthcare delivery were restricted travel (78.3%) and fear of contracting COVID-19 (68.8%). Telemedicine (67.4%) was the commonest alternate strategy deployed for continuing care of patients. Conclusion: Several challenges exist to maintain the continuity of healthcare services to pediatric non-COVID patients especially in those with chronic diseases, poor financial background, and follow-up in COVID government hospitals. Use of telemedicine, strategic preplanning, strengthening peripheral healthcare, and optimal resource reallocation may help reduce the broader health impact of the COVID-19 pandemic.
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COVID-19大流行对非covid儿童患者护理的影响:来自印度的医护人员调查
背景:与2019冠状病毒病(COVID-19)大流行相关的医疗保健重新调整,以及保持社交距离的需求、全面或部分封锁以及日益严重的经济危机,为非COVID-19患者获得医疗保健服务造成了巨大障碍。目的:我们旨在评估照顾儿科患者的印度医护人员对儿科非covid疾病医疗服务障碍的看法。方法:使用预先设计的在线问卷(2020年5月),对在公共和私营部门工作的照顾儿科患者的印度卫生保健工作者进行了为期1个月的调查。使用李克特量表对医疗保健服务的影响进行评分。结果:在获得的356份回复中,75.3%的人报告了COVID-19大流行对向未感染COVID-19的儿科患者提供医疗保健的显著负面影响。政府医院和新冠肺炎医院的受访者报告的影响分别显著高于私营医院(P = 0.0002)和非新冠肺炎医院(P = 0.01)。受访医护人员报告的非新冠肺炎患者门诊就诊人数(86.2%)、住院人数(71.6%)、常规手术次数(81.7%)和急诊手术次数(60.5%)、诊断程序次数(61.2%)和计划治疗次数(50.2%)均显著下降。导致医疗服务中断的最重要因素是旅行受限(78.3%)和担心感染COVID-19(68.8%)。远程医疗(67.4%)是对患者进行持续护理的最常见替代策略。结论:维持对非COVID儿童患者的医疗保健服务的连续性存在一些挑战,特别是慢性病患者、经济背景差的儿童,以及在COVID政府医院的随访。使用远程医疗、战略性预先规划、加强外围医疗保健和优化资源重新分配可能有助于减少COVID-19大流行对健康的更广泛影响。
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