Impact of COVID-19 on respiratory function testing in Australian laboratories

The COVID-19 pandemic caused disruption of respiratory laboratory services worldwide, with international respiratory societies recommending testing limitations.

Our study aimed to quantify the impact of COVID-19 on laboratory-based respiratory function tests (RFTs) in Australia using data from Australia's publicly funded universal healthcare system, Medicare.

We examined the online Medicare database for repeated cross-sectional data to understand pre-pandemic data trends, from July 1994 (earliest data) to September 2023. All laboratory-based Medicare items related to RFTs were included, encompassing those before and after related changes in the Medicare Benefits Schedule implemented in 2018.

Following the COVID-19 pandemic declaration in March 2020, there was a 45% fall (100 924 to 55 896) in laboratory-based RFTs in Australia in the second quarter of 2020, compared with the same quarter the previous year. The yearly fall was 19% in 2020 (326 685) compared with 2019 (404 593). This was against the background of a yearly average±standard deviation increase in testing numbers of 7±3% from 1995 to 2018, followed by a 7% reduction in 2019 after Medicare changes. Fluctuations in testing were noted throughout 2020, 2021 and 2022, which state-based data suggested were related to local lockdown conditions and COVID-19 case numbers.

Our analysis highlights the substantial impact that the COVID-19 pandemic had on laboratory-based Medicare-funded respiratory function testing in Australia. State-based fluctuations in testing numbers suggest the need for similar analysis elsewhere to fully understand the impact that COVID-19 had on respiratory laboratories worldwide.