Paediatric Upper Respiratory Infection in Colombia: 10-Year Nationwide Trends in Healthcare Utilization From...

Upper respiratory tract infections (URTIs) are amongst the commonest reasons for paediatric care, yet national evidence from Latin American middle-income health systems remains limited. We used the COVID-19 pandemic as a system shock to examine whether paediatric URTI care returned to its pre-pandemic trajectory or settled into a new service configuration.

We performed a nationwide population-based time-series study using Colombia's administrative healthcare registry (RIPS) linked to official population projections (DANE) for children and adolescents aged 0-17 years from 2015 to 2024 (ICD-10 J00-J06). We estimated crude and age-standardized utilization rates per 100 000, characterized diagnostic and service-type composition, quantified service-mix reconfiguration and fitted segmented Poisson models with population offsets by age group.

We analyzed 14 173 511 URTI attended-person records. National rates increased from 11 139 per 100 000 in 2015 to 14 421 in 2019, fell to 4993 in 2020, and plateaued near 9806 by 2024. By 2024, observed utilization was approximately 50% below the trajectory expected from 2015 to 2019 growth. Children aged 0-4 years accounted for 56.4% of all records and had the largest absolute burden (pooled rate approximately 21 000 per 100 000). Croup/epiglottitis represented only 2.1% of all contacts but 11.3% of URTI hospitalizations, with a hospitalization enrichment ratio of 5.44.

Colombia's paediatric URTI utilization did not simply recover after the pandemic shock; it reconfigured. By 2024, emergency-department and hospitalization rates remained 45% and 40% below their 2019 levels, respectively, while procedure-based contacts made up a larger share of care. This persistent shift, together with the concentration of severe-service use in children under 5 years and in croup-like diagnoses, identifies actionable targets for respiratory capacity planning, surveillance and post-shock health-system monitoring.