To investigate the impact of COVID-19 epidemic on pediatric outpatient and emergency department and the possible causes, to provide reference for optimizing children′s medical-seeking pattern and achieving children′s hierarchical diagnosis and treatment.

A self-designed questionnaire was used to investigate the children who visited the pediatric outpatient or emergency department of Peking University First Hospital from 08:00 on February 25, 2020 to 08:00 on the next day, as well as their accompanying relatives and corresponding doctors. A semi-structured interview method was used to collect data from pediatricians responsible for the outpatient and emergency department during the COVID-19 epidemic.

A total of 77 valid questionnaires were returned with a response rate of 87.5%, which showed that almost half of the children (51.9%, 40/77) were absent and their parents described the main complaints. Forty-four (57.2%, 44/77) visits resulted from consulting/prescription, and the other 33 (42.8%, 33/77) were led by various complaints, among which the five leading complaints were fever, cough, rash, jaundice, and premature baby follow-up, the five leading diseases were pneumonia, suppurative tonsillitis, upper respiratory infection, neonatal jaundice, and the follow-up of premature infants. Of these 33 visits, 13 (39.4%) cases were evaluated by their corresponding doctors as being able to get diagnosed and treated at a qualified primary medical institution instead of coming here, and 21 (63.6%) and 5 (15.2%) cases were considered to be able to get some and all problems solved through online consultation, respectively. The qualitative interview results showed that since the outbreak of COVID-19, the number of children visiting outpatient or emergency department had reduced significantly. Compared with the situation before the epidemic, the conditions of children visiting emergency department became more complicated, while those of children visiting outpatient department became simpler. Meanwhile, the doctor-patient relationship became more harmonious. In the future, multiple measures should be taken to promote the triage of outpatient and emergency patients visiting pediatrics department of tertiary hospitals or Children′s Hospital.

The epidemic of COVID-19 has a huge impact on the health-seeking behavior of children and their parents in the outpatient and emergency department of general hospitals. In the future, we should strength medical science education for parents, develop online medical consultation, improve the routes of drug availability for chronic disease patients, strengthen doctor training, and develop medical conjoined body, so as to change the children′s medical care behavior and promote the implementation of hierarchical medical system in children.