The impact of the two-year Covid-19 pandemic on hospital readmissions to a child and adolescent neuropsychiatric unit

Abstract

Abstract Background Since2020 Italy and the world have been facing the health emergency related to the COVID-19 pandemic. Increasing evidence supports the association between the COVID-19 pandemic and the worsening mental health conditions of children and adolescents, with increased accesses in Emergency Departments and hospitalizations for psychiatric problems. This paper aimed to (a) study the population of patients admitted to a Neuropsychiatric Hospital Unit of North Italy during the pandemic two-year period, throughout a comparison with the population of patients hospitalized in the previous two years, according to socio-demographic and clinical variables (b) analyse the hospital readmission phenomenon, which has apparently increased its frequency during the first pandemic year according to recent studies. Methods This is an observational retrospective cohort study about 375 hospitalised patients from February 2018 to March 2022 due to neuropsychiatric problems. Data wereanalysed through mean, standard deviation, percentages, t-tests, chi-squared test, Fischer’sand non-parametric Mann-Whitney U-test. The level of statistical significance was set at p ≤ 0.05. Results Risk factors for mental health disorders were similar between the two groups, except for the significantly increased use of electronic devices in the COVID-19 one. Patients suffering from eating disorders tripled over time. Hospital readmissions almost doubled between the pre-COVID-19 two-year period and the COVID-19 period: 75% of patients hospitalized three or more times in the last two years and 85.7% of the so called “revolving door “patients (with relapse within three months after discharge) both belonged to the COVID-19group. The comparison between the two groups of patients readmitted before and during the COVID-19 pandemic didn’t show any differences in terms of socio-demographic and clinical characteristics. Conclusions These results suggest the inadequacy of local neuropsychiatric services in managing the complexity of clinical situations and the necessity to implement prevention strategies and services.