Paediatric Healthcare Utilisation Trends From the Pre‐Pandemic Period Through Two Years Post–
COVID
‐19: Evidence From a Nationwide Big‐Data Analysis
Einat Shmueli, Elite Gutman, Joseph Levy, Maya Sagiv, Noam Wygoda, Hagit Levine, Patrick Stafler, Benjamin Rothschild, Meir Mei‐Zahav, Dario Prais, Ophir Bar‐On ABSTRACT
Aim
The COVID‐19 pandemic was associated with a marked decline in respiratory infections and asthma exacerbations in children. Following the easing of restrictions, a rebound in respiratory morbidity was observed. However, the long‐term impact on paediatric asthma remains unclear.
Methods
We conducted a retrospective study using data from the largest healthcare provider in Israel. Children aged 2–18 years with recurrent wheezing or clinician‐diagnosed asthma were included. Healthcare utilisation between January 2019 and July 2023 was analysed.
Results
A total of 209 954 children, mean age 6.8 years (56.9% male), were included. During winter 2020–2021, compared with winter 2019–2020, healthcare utilisation declined significantly for chest radiographs (CXR) (RR = 0.69), asthma medication dispensing (RR = 0.67), and emergency department (ED) visits (RR = 0.61). After restrictions were lifted, all outcomes rose sharply, peaking in summer 2021. By winter 2022–2023, rates of CXR (RR = 1.30), asthma medication dispensing (RR = 1.03), ED visits (RR = 1.04), and hospitalisations (RR = 1.30) remained significantly higher than pre‐pandemic levels across all age groups.
Conclusion
Paediatric respiratory‐related healthcare utilisation exceeded pre‐pandemic levels during the first and second post‐pandemic winters. These findings highlight the unpredictable, long‐lasting, and indirect consequences of pandemic‐era interventions on respiratory health.