More on Population Health

Pediatric emergency visits, hospitalizations down sharply during pandemic

The trend is likely linked to public health measures instituted during the COVID-19 pandemic, such as masking and social distancing.

Jeff Lagasse, Associate Editor

Amid the COVID-19 pandemic, children's hospitals across the U.S. have seen significant reductions in the number of children being treated for common pediatric illnesses like asthma and pneumonia, according to a new multicenter study led by Monroe Carell Jr. Children's Hospital at Vanderbilt.

Researchers at Children's Hospital found that 42% fewer children were being seen and hospitalized at 44 children's hospitals across the U.S. for both respiratory and non-respiratory illnesses, with the most significant reduction seen in children under age 12. Hospitals saw a decline in the number of children seen or hospitalized for respiratory illness by 62%, while there was 38% reduction for non-respiratory illnesses.

The trend, they believe, is likely linked to public health measures instituted during the COVID-19 pandemic – masking, social distancing and handwashing – as well as reduced school and extracurricular activities among children and adolescents.

The study, "The COVID-19 Pandemic and Changes in Healthcare Utilization for Pediatric Respiratory and Non-Respiratory Illnesses in the United States," was published in the Journal of Hospital Medicine.

The large multicenter study evaluated emergency department visits and hospitalizations for respiratory and non-respiratory illness at 44 U.S. children's hospitals in 2020.


Using data reported to the Pediatric Health Information System database maintained by the Children's Hospital Association, researchers looked at children ages 2 months to 18 years who had been discharged from an ED or inpatient setting with a non-surgical diagnosis between January 1 and September 30, comparing encounter volumes in 2020 with average volumes for 2017-19.

During the study period, when COVID was widespread (from May to September), researchers found the overall reductions for ED visits/hospitalizations for each respiratory illness across all age groups varied by type: asthma-related encounters dropped by 76%; pneumonia dropped by 81%; croup by 84%; influenza by 87%; and bronchiolitis by 91%.

When comparing age groups, the study found that adolescents had smaller reductions in both respiratory and non-respiratory illnesses compared to younger children.

The numbers are encouraging from a public health perspective, and lend credence to the growing notion that the nation – and its beleaguered healthcare system – may be slowly clawing their way back from the ongoing pandemic.

They also indicate that the pandemic response measures have been effective at reducing the transmission of common respiratory pathogens. ED visits were greatly reduced for common pediatric illnesses such as asthma, influenza and pneumonia, which are a common cause of hospitalizations among children.

Further study is needed to continue to understand the reasons why fewer children went to the ED or had to be hospitalized, and to evaluate if families sought treatment in alternative care settings such as telehealth visits.


In September 2020, the Centers for Medicare and Medicaid Services released data that shows children in Medicaid and on the Children's Health Insurance Program have low rates of vaccination, and of primary and preventive services.

Then-CMS Administrator Seema Verma said that what's needed to solve the problem of foregone medical care is state and community leadership, as well as outreach to families to assure them it's safe to seek medical care for children.

Twitter: @JELagasse
Email the writer: