September 16, 2025Open Access

Examining Pediatric Emergency Utilization Trends Before and After the COVID-19 Pandemic: An Eight-Year Cohort Study from a South Korean Tertiary Center

HLHae Jeong LeeSamsung (South Korea)YKYechan KyungChangwon National University DKDong Wan KangSamsung (South Korea)

Key Points

Pediatric emergency visits decreased by 55.5% since the COVID-19 pandemic, indicating a significant shift in healthcare utilization.
Analysis of 71,560 pediatric ED visits reveals demographic and clinical changes, including discharge rates and admission reductions.
Categorization of patients by age and triage severity reflects distinct patterns of health service use during different time periods.
Findings underline the urgency for targeted strategies in pediatric public health policy to address pandemic-related changes.

Abstract

Purpose: This study investigates trends in pediatric emergency department (ED) utilization before and after the COVID-19 pandemic, with a focus on age-specific patterns, triage severity, diagnostic categories, and clinical presentations. Methods: Data were collected for 71,560 individuals (40,428 males and 31,132 females aged 0–18 years) who visited the ED at Samsung Changwon Hospital between 1 January 2016 and 31 December 2023. Patients were categorized into pre-COVID-19 (2016–2019) and post-COVID-19 (2020–2023) periods. Age, Korean Triage and Acuity Scale (KTAS) scores, visit outcomes, diagnostic codes (ICD-10), and vital signs were analyzed. Age-specific analyses were performed in four groups: <12 months, 1–6 years, 7–12 years, and 13–18 years. Results: Since the COVID-19 pandemic, pediatric ED visits have decreased by 55.5%. The proportion of visits by infants (<12 months) and young children (1–6 years) decreased, and adolescent visits increased. Post-pandemic, there was a significant increase in lower-acuity visits (KTAS 4) and discharge rates, alongside a reduction in admissions. Visits for respiratory and infectious diseases (ICD-10 J and A & B codes) decreased markedly, and visits for non-specific symptoms (R codes) and trauma (S & T codes) increased. The mean body weight of young children increased significantly after the COVID-19 period. Conclusions: The COVID-19 pandemic has had a profound and lasting effect on pediatric emergency department utilization, with changes in the number of visits, illness patterns, and severity by age group. These findings highlight the need for age-specific strategies in emergency planning and pediatric public health policy, particularly in managing the indirect effects of pandemic-induced changes in behavior and access to healthcare.

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