Child/Adolescent Health

Pediatric emergency department visits surged during the 2009 H1N1 flu pandemic, but few children were hospitalized

During the peak of the April to July 2009 H1N1 influenza pandemic, there was a substantial 29 percent increase in the number of pediatric emergency department (ED) visits and a 51 percent increase in influenza-related illness (IRI) visits, according to a new study. Overall, 61 percent—14 of 23 children’s hospitals studied—experienced a surge in ED volume, with an average increase of 49 ED visits per ED day. Surge patients with IRI were less ill than expected. For example, the percentage of children admitted from the ED to intensive care unit (ICU) beds and non-ICU beds were 56 percent and 30 percent lower than expected.

Overall patient acuity also remained low, with only 5 percent of children hospitalized, and only 0.01 percent requiring mechanical ventilation. Higher-than-expected ED IRI visits were seen for children 2 to 17 years old (highest for ages 9 to 17), females, Hispanics, the insured, and those with asthma. Lower-than-expected ED-IRI visits were seen for children under age 2, the uninsured, those with immune deficiencies or cardiovascular disease, and those in the Middle Atlantic region. Marion R. Sills, M.D., M.P.H., of the University of Colorado School of Medicine, and colleagues used data from the Pediatric Health Information System, which contains demographic and health care resource utilization data for 41 nonprofit children’s hospitals across the U.S.

Twenty-three of the hospitals had ED data available continuously from 2004 through 2009, permitting calculation of expected utilization prior to the pandemic. Overall, the 23 hospitals reported 390,983 ED visits and 88,885 ED-IRI visits during the 14-week study period (April–July 2009). The study was funded in part by the Agency for Healthcare Research and Quality (HS16418). More details are in "Resource burden at children’s hospitals experiencing surge volumes during the Spring 2009 H1N1 influenza pandemic," by Dr. Sills, Matthew Hall, Ph.D., Harold K. Simon, M.D., M.B.A., and others in the February 2011 Academic Emergency Medicine 18(2), pp. 158-166.

Research Activities, November 2011: Child/Adolescent Health: Pediatric emergency department visits surged during the 2009 H1N1 flu pandemic, but few children were hospitalized