{"id":27957,"date":"2025-05-10T04:27:00","date_gmt":"2025-05-09T20:27:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=27957"},"modified":"2025-05-10T07:12:55","modified_gmt":"2025-05-09T23:12:55","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd%e5%84%bf%e7%ab%a5%e5%8c%bb%e9%99%a2%e5%91%bc%e5%90%b8%e9%81%93%e6%b2%bb%e7%97%85%e7%bb%b4%e7%94%9f%e7%b4%a0%e6%a3%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27957","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd\u513f\u7ae5\u533b\u9662\u547c\u5438\u9053\u81f4\u75c5\u5fae\u751f\u7269\u7684\u68c0\u6d4b\u8d8b\u52bf"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Pediatrics<\/p>\n\n\n\n

March 6, 2025<\/p>\n\n\n\n

Trends in Respiratory Pathogen Testing at US Children\u2019s Hospitals<\/h1>\n\n\n\n

Matthew J. Molloy, Matthew Hall, Jessica L. Markham, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2025;8(3):e250160. doi:10.1001\/jamanetworkopen.2025.0160<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  How have respiratory pathogen testing rates and costs changed over time for children and adolescents with acute respiratory infections, both before and after the onset of the COVID-19 pandemic?<\/p>\n\n\n\n

Findings<\/strong>  In this cross-sectional study of 5\u202f090\u202f923 children\u2019s hospital encounters, respiratory pathogen testing rates were increasing prior to the onset of the COVID-19 pandemic, with large increases at onset that have persisted; after the pandemic, COVID-19\u2013only testing decreased, while large-panel testing continued to increase. Testing costs increased from 2016 to 2023.<\/p>\n\n\n\n

Meaning<\/strong>  The findings of this study suggest that the COVID-19 pandemic was associated with increased respiratory pathogen testing rates and costs that have persisted, supporting a need for future deimplementation efforts.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood.<\/p>\n\n\n\n

Objective<\/strong>  To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (aged <18 years) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This retrospective serial cross-sectional study included emergency department (ED) encounters and hospitalizations in US children\u2019s hospitals among children and adolescents with a primary acute infectious respiratory illness diagnosis. Data were ascertained from the Pediatric Health Information System database from January 1, 2016, to December 31, 2023.<\/p>\n\n\n\n

Exposure<\/strong>  Respiratory pathogen testing.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was the percentage of encounters with respiratory testing over time. Interrupted time series models were created to assess the association of COVID-19 with testing patterns. The inflation-adjusted standardized unit cost associated with respiratory testing was also examined.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0There were 5\u202f090\u202f923 eligible encounters among patients who were children or adolescents (mean [SD] age, 3.36 [4.06] years); 55.0% of the patients were male. Among these encounters, 87.5% were ED only, 77.9% involved children younger than 6 years, and 94.5% involved children without complex chronic conditions. Respiratory testing was performed in 37.2% of all encounters. The interrupted time series models demonstrated increasing prepandemic testing rates in both ED-only encounters (slope, 0.26 [95% CI, 0.21-0.30];\u00a0P<\/em>\u2009<\u2009.001) and hospitalizations (slope, 0.12 [95% CI, 0.07-0.16];\u00a0P<\/em>\u2009<\u2009.001). Increases in respiratory testing were seen at the onset of the COVID-19 pandemic in both ED-only encounters (level change, 33.78 [95% CI, 31.77-35.79];\u00a0P<\/em>\u2009<\u2009.001) and hospitalizations (level change, 30.97 [95% CI, 29.21-32.73];\u00a0P<\/em>\u2009<\u2009.001), associated initially with COVID-19\u2013only testing. Postpandemic testing rates remained elevated relative to prepandemic levels. The percentage of encounters with respiratory testing increased from 13.6% [95% CI, 13.5%-13.7%] in 2016 to a peak of 62.2% [95% CI, 62.1%-62.3%] in 2022. While COVID-19\u2013only testing decreased after 2020, other targeted testing and large-panel (>5 targets) testing increased. The inflation-adjusted standardized unit cost associated with respiratory testing increased from $34.2 [95% CI, $33.9-$34.6] per encounter in 2017 to $128.2 [95% CI, $127.7-$128.6] per encounter in 2022.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  The findings of this cross-sectional study suggest that respiratory testing rates have increased over time, with large increases at the onset of the COVID-19 pandemic that have persisted. Respiratory testing rates and related costs increased significantly, supporting a need for future deimplementation efforts.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Pediatrics March 6,&n […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27957"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27957"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27957\/revisions"}],"predecessor-version":[{"id":28249,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27957\/revisions\/28249"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27957"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27957"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}