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How Has the COVID-19 Pandemic Affected the Healthcare Utilization in Children and Young Adults with Asthma - a Canadian Population Study

31 Pages Posted: 11 Apr 2022

See all articles by Teresa To

Teresa To

University of Toronto - Child Health Evaluative Sciences

Kimball Zhang

University of Toronto - Child Health Evaluative Sciences

Emilie Terebessy

University of Toronto - Child Health Evaluative Sciences

Jingqin Zhu

University of Toronto - Child Health Evaluative Sciences

Christopher Licskai

Western University - Schulich School of Medicine and Dentistry

More...

Abstract

Background: Literature is limited regarding the COVID-19 pandemic’s impact on health services use in younger Canadian populations with asthma.   Methods: We utilized health administrative databases from January 2019– December 2021 for a population-based cross-sectional study to identify Ontario residents 0-25 years old with physician-diagnosed asthma and calculate rates of healthcare use. Multivariable negative binomial regression analysis was used to adjust for confounders.   

Findings: We included 716,690 children and young adults ≤25 years. There was a sharp increase of ICS and SABA prescription rates at the start of the pandemic (March 2020) of 61·7% and 54·6%, respectively. Monthly virtual physician visit rates increased from zero to 0 · 2 3 per 100 asthma population during the pandemic. After adjusting for potential confounders, rate ratios (RR) with 95% confidence intervals (CI) showed that the pandemic was associated with significant decrease in hospital admissions (RR= 0·21 , 95% CI: 0·18 -0·24 ), emergency department visits (RR= 0·35, 95% CI: 0·34-0·37), and physician visits (RR= 0·61, 95% CI: 0·60-0·61 ). ICS and SABA prescriptions filled also significantly decreased during the pandemic (RR= 0·58 , 95% CI: 0·57-0·60 and RR= 0·4 7, 95% CI: 0·46-0·48 , respectively ).     

Interpretation: This Canadian population-based asthma study demonstrated a dramatic decline in physician and emergency department visits, hospitalizations, and medication prescriptions filled during the COVID-19 pandemic. A fulsome evaluation of the factors contributing to an 80 % reduction in the risk of hospitalization may inform post-pandemic asthma management.

Funding Information: This study was funded by the Ontario Ministry of Health (MOH). Dr. Teresa To is funded by a Canadian Institutes of Health Research Tier 1 Canada Research Chair in Asthma. This study was also supported by ICES (formerly known as the Institute for Clinical Evaluative Sciences), which is funded by an annual grant from the Ontario MOH and the Ministry of Long-Term Care (MLTC).

Declaration of Interests: Dr. Chris Licskai reports personal fees and other from AstraZeneca, personal fees and other from GlaxoSmithKline, grants and personal fees from Novartis, personal fees from Teva, other from Sanofi Genzyme, personal fees from Valeo Pharma, outside the submitted work. All other authors have nothing to declare.

Ethics Approval Statement: Ethics approval exemption was obtained from the Hospital for Sick Children Research Ethics Board (Toronto, Ontario, Canada).

Keywords: Asthma, Health services use, ICS, SABA, Asthma medication use, COVID-19 pandemic

Suggested Citation

To, Teresa and Zhang, Kimball and Terebessy, Emilie and Zhu, Jingqin and Licskai, Christopher, How Has the COVID-19 Pandemic Affected the Healthcare Utilization in Children and Young Adults with Asthma - a Canadian Population Study. Available at SSRN: https://ssrn.com/abstract=4049627 or http://dx.doi.org/10.2139/ssrn.4049627

Teresa To (Contact Author)

University of Toronto - Child Health Evaluative Sciences ( email )

Toronto, Ontario
Canada

Kimball Zhang

University of Toronto - Child Health Evaluative Sciences ( email )

Toronto, Ontario
Canada

Emilie Terebessy

University of Toronto - Child Health Evaluative Sciences ( email )

Toronto, Ontario
Canada

Jingqin Zhu

University of Toronto - Child Health Evaluative Sciences ( email )

Toronto, Ontario
Canada

Christopher Licskai

Western University - Schulich School of Medicine and Dentistry ( email )

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