Healthcare utilization in Canadian children and young adults with asthma during the COVID-19 pandemic

Abstract

Literature is limited regarding the COVID-19 pandemic’s impact on health services use in younger Canadian populations with asthma. 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. 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 0.23 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 = 0.47, 95% CI: 0.46–0.48, respectively). 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. An extensive evaluation of the factors contributing to an 80% reduction in the risk of hospitalization may inform post-pandemic asthma management.

Analyzing COVID-19 and Air Pollution Effects on Pediatric Asthma Emergency Room Visits in Taiwan

“…Pediatric asthma exacerbations decreased during the COVID-19 period in Northern Italy compared with the historical data [ 35 ]. In Canada, during the COVID-19 period, there were reductions in hospitalization (RR = 0.21), ERVs (RR = 0.35), and outpatient visits (RR = 0.61) in children and young adults with asthma [ 36 ]. The results of our study are similar and likely reflect the strict hygiene and social distancing measures adopted in 2020 during the COVID-19 pandemic.…”

“…Pediatric asthma exacerbations decreased during the COVID-19 period compared to the previous 5 years in northern Italy [ 35 ]. There are fewer ERVs and hospitalizations of children with asthma in the United States and Canada [ 29 , 36 ]. The reasons for this reduction in asthma ERVs are multifactorial and may include decreased viral infections, restrictive measures, and reduced traffic-related air pollution (TRAP) [ 35 , 36 ].…”

“…There are fewer ERVs and hospitalizations of children with asthma in the United States and Canada [ 29 , 36 ]. The reasons for this reduction in asthma ERVs are multifactorial and may include decreased viral infections, restrictive measures, and reduced traffic-related air pollution (TRAP) [ 35 , 36 ]. However, there is a lack of information regarding pediatric asthma ERVs in Taiwan, and this issue requires further study.…”

Mode of delivery and birth outcomes before and during COVID-19 –A population-based study in Ontario, Canada

“…On the other hand, results from an online international cross-sectional survey with participants from high income countries (USA, Ireland and the UK) [9] suggested the lack of access to antenatal care coupled with reduced family/social support potentially intensified pregnancy specific stress. It was shown in Canada that during the COVID-19 pandemic, all-cause health services, including antenatal care, declined dramatically, particularly during the lockdowns [10,11]. The decline may partially be attributed to physicians helping patients avoid the emergency department (ED) or practicing more cautious medicine to avoid complications.…”