338 - Incidence of Hospital admissions for Eating Disorders during the pandemic; a Canadian population cohort

Poster Number: 338
Publication Number: 338.623

Background: Public health measures deployed to minimize hospitalizations and death from COVID-19 impacted child well-being indirectly. While there was an immediate drop in mental health related hospital admissions at the start of the pandemic, there has been a subsequent rise in hospitalizations for some of these conditions. Specifically, there was an abrupt rise in admissions for eating disorders in pediatric centers in the early pandemic.

Objective: The objective is to use the Canadian population to estimate the difference in incidence of hospitalizations for eating disorders, in youth comparing pre vs pandemic period.

Design/Methods: This is a Canadian population-based study using health administrative data, extending from April 1st 2016 to March 31st 2023, and divided into pre- and during- pandemic periods. We included children from 6 to 21 years of age. Data was provided by Discharge Abstract Database (DAD) of the Canadian Institute for Health Information (CIHI), and the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for Quebec. Population estimates ( < 21 years) are provided from Statistics Canada. The primary outcome was hospitalization for a primary diagnosis of eating disorder (ICD10 code F50) to any facility. Interrupted time series quantified the impact of pandemic phases on the primary outcome by applying segmented regression analysis with multiple interruptions and exposures (provincial stringency and school closures).

Results: During the study period, there were 11,289 admissions for eating disorders across Canada. Over 90% of admissions were females, and over 80% were aged 12-17 years. Amongst the females aged 12-17 years, the incidence rate of admissions for eating disorders during the pandemic increased almost two-fold in BC (RR 1.83), Prairies (RR 1.83), Ontario (RR 1.91), and Quebec (2.03). There was a significant increase in the pre-pandemic level of admissions (p < 0.001), and the stringency was significantly associated with increased admissions (p=0,003), across all regions. School closure alone was significantly associated with increased risk of admissions, although became insignificant when stringency was included.

Conclusion(s): In Canada, there was a significant rise in hospital admissions for eating disorders in females aged 12-17 years during the pandemic. A significant association between public health measures and increased risk of hospitalization was identified, although the effect of school closures alone could not be distinguished from overall stringency. Future public health planning, will need to increase resources and support for girls in this age group.