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Area of Science:

  • Pediatric infectious diseases
  • Health services research
  • Epidemiology

Background:

  • Respiratory pathogen testing is a common focus for deimplementation.
  • The COVID-19 pandemic introduced new complexities to respiratory testing practices.
  • Understanding recent trends in pediatric respiratory testing rates and costs is crucial.

Purpose of the Study:

  • To measure trends in respiratory testing for acute respiratory infections in children (<18 years) from 2016-2023.
  • To assess the impact of COVID-19 on these testing trends.
  • To describe associated cost trends for respiratory pathogen testing.

Main Methods:

  • Retrospective serial cross-sectional study using the Pediatric Health Information System database (2016-2023).
  • Included emergency department (ED) encounters and hospitalizations for acute infectious respiratory illness in US children's hospitals.
  • Interrupted time series models analyzed testing patterns and costs, adjusting for inflation.

Main Results:

  • Respiratory testing increased from 13.6% in 2016 to a peak of 62.2% in 2022.
  • The COVID-19 pandemic onset saw significant increases in testing rates (ED-only: 33.78%, hospitalizations: 30.97%).
  • Inflation-adjusted costs per encounter rose from $34.2 in 2017 to $128.2 in 2022.

Conclusions:

  • Pediatric respiratory testing rates have substantially increased, with sustained elevation post-pandemic.
  • Significant increases in testing rates and associated costs necessitate future deimplementation efforts.
  • Findings support the need to re-evaluate and optimize respiratory pathogen testing strategies in pediatric care.