Coronavirus disease 2019 pandemic related changes in pediatric patient numbers in Tokushima, Japan

In this study, we aimed to investigate the impact of the COVID-19 pandemic on the number of pediatric inpatients and outpatients visiting medical institutions in Tokushima Prefecture, Japan. We evaluated medical claims data of individuals aged <15 years insured by the National Health Insurance. We calculated the mean and 95% confidence interval (CI) of the monthly number of inpatient and outpatient medical claims per 1,000 children for fiscal year 2019 (FY2019), the pre-pandemic period, and fiscal year 2020 (FY2020), the pandemic period. The mean monthly number of inpatients aged <15 years (per 1,000 children) was 27.6 (95% CI:24.7-30.4) in FY2019 and 16.9 (95% CI:14.9-18.9) in FY2020. For outpatients, the corresponding numbers were 638.1 (95% CI:610.6-665.6) in FY2019 and 501.1 (95% CI:471.0-531.0) in FY2020. We applied multivariable negative binomial regression to calculate incident rate ratios (IRRs). The inpatient IRR was 0.58 (95% CI:0.42-0.80), showing a significant decrease, while the outpatient IRR was 0.79 (95% CI:0.57-1.09), showing no significant difference from FY2019. These results suggest that pediatric inpatient and outpatient visits decreased during the COVID-19 pandemic, with a larger impact observed for inpatients. The pandemic likely influenced healthcare-seeking behavior and medical service utilization among children. J. Med. Invest. 72 : 401-407, August, 2025.