Table 1. Changes in the number of pediatric patients during the COVID-19 pandemic, by visit type and hospital level.

Visit type	Hospital level	No. of site	January–April		Percent change (%)	P†
			2019 (comparison)	2020 (COVID-19)
Outpatient department	First-level	9	16,212	9,201	−43.3	<0.0001
	Second-level	73	778,703	355,049	−54.4
	Third-level	58	1,567,360	803,976	−48.7
	All	140	2,362,275	1,168,226	−50.6
Emergency department	First-level	1	296	15	−94.9	<0.0001
	Second-level	35	143,946	78,209	−45.7
	Third-level	45	917,042	363,348	−60.4
	All	81	1,061,284	441,572	−58.4
Observation room	First-level	1	112	25	−77.7	<0.0001
	Second-level	22	26,827	11,871	−55.8
	Third-level	40	240,051	75,190	−68.7
	All	63	266,990	87,086	−67.4
Inpatient care	First-level	8	5,210	2,089	−59.9	<0.0001
	Second-level	69	114,463	61,202	−46.5
	Third-level	59	146,243	86,927	−40.6
	All	136	265,916	150,218	−43.5
Neonatal inpatient care	First-level	1	139	86	−38.1	<0.0001
	Second-level	60	16,948	13,353	−21.2
	Third-level	55	26,705	19,814	−25.8
	All	116	43,792	33,253	−24.1
PICU	First-level	0
	Second-level	6	300	205	−31.7	0.0087
	Third-level	28	8,060	4,312	−46.5
	All	34	8,360	4,517	−46.0
All types	First-level	9	21,830	11,330	−48.1	<0.0001
	Second-level	74	1,063,939	506,331	−52.4
	Third-level	59	2,870,696	1,329,441	−53.7
	All	142	3,956,465	1,847,102	−53.3

^†, type III P values for the interaction between the overall change among all hospitals and change in each hospital levels. A type III P values <0.05 indicated that changes were disproportionate among different hospital levels. PICU, pediatric intensive care unit; COVID-19, 
coronavirus disease 2019.