P3B241: An Exploratory Analysis of Changes in Regular Healthcare Utilization During Pandemic Lockdown

Background: Access to regular healthcare is essential to preventing injury and illness among children and reducing the overall burden of disease within the healthcare system. Prevention is particularly important during states of emergency such as the ongoing COVID-19 pandemic in which patterns of healthcare access changed. We aim to explore differences in healthcare utilization for the COVID-19 lockdown and post-lockdown periods to better understand healthcare needs, utilization, and preventative healthcare access and health seeking behavior that may have changed during the pandemic.

Methods: The B-WELL-Mom Follow-Up Study engages a subset of 128 mothers from an existing cohort of 415 mothers enrolled in a study to increase understanding of factors about asthma control. Mothers completed follow-up surveys, administered via the Qualtrics, utilizing standardized questionnaires. For this study, we analyzed repeated survey measures related to child chronic conditions, health insurance coverage, child injury and illness requiring immediate care, and number of pediatric non-urgent doctor visits. Survey data for two-time periods (lockdown: 4/2020-12/2020 and post-lockdown: 1/2021-12/2021) were analyzed. We evaluated differences in proportions in healthcare utilization using McNemar’s exact test.

Results: Data were collected from 113 mothers. The average age of mother and child were 36 years (±6) and 3 years (±1), respectively. 71 participants (58.7%) reported that their child had one (or more) conditions: asthma, wheezing, eczema, or allergies during either of the two time periods. 89 (74.2%) of participants reported having private insurance; 57 (51%) of the sample reported being white as their primary race (see Table 1 for full demographic characteristics). The number of doctor visits for each respective time-period were dichotomized into ≤ 2 visits or ≥3 visits. Mothers were more likely to report their child needed care right away during lockdown than post-lockdown (58% vs. 32%, p <.001), and this trend remained significant when stratified by whether the child had a chronic illness or not (both ps <.05). Mothers were also more likely to say that their child visited a doctor’s office 3+ times during lockdown than post-lockdown (57% vs. 29%), and this remained significant when stratified by childhood chronic condition (both ps <.001).

Conclusion: Mothers reported higher need for pediatric healthcare and higher pediatric healthcare utilization during the COVID-19 pandemic lockdown compared with after lockdown. This pattern was consistent among children with and without chronic conditions. Insurance status did not change during lockdown vs. post lockdown, so it does not appear that the change in pediatric healthcare need and utilization can be explained by changes in insurance. Factors beyond those explored in this study (e.g., routine availability of telemedicine, remote work access) merit further attention as potential drivers of overall healthcare utilization and accessibility.