Abstract
Introduction: Universal cholesterol screening during childhood has been recommended by the American Academy of Pediatrics since 2011, but most children remain unscreened. We hypothesized that the COVID-19 pandemic and subsequent disruptions in routine healthcare impacted pediatric cholesterol screening rates and may have disproportionately affected children based on race, ethnicity, socioeconomic status (SES), or rural/urban status. Hypothesis: The COVID-19 pandemic impacted pediatric lipid screening rates based on race, ethnicity, SES, and rural/urban status. Methods: The provider order placement rate (OPR) for a screening cholesterol panel was calculated for established patients 9-21 years old at a single institution pre-pandemic (3/18/2019-3/17/2020), mid-pandemic (3/18/2020-3/17/2021), late-pandemic (3/18/2021-3/17/2022), and post-pandemic (3/18/2022-12/31/2022). OPR was analyzed, including a chi-squared test, based on race, ethnicity, SES, rural/urban status, and the department of the visit. Results: Overall OPR fell over time and in both pediatric and family medicine specialties. There was a decrease in OPR across all race and ethnicity groups, though most did not reach statistical significance. Urban advantaged, urban, and rural underserved had a disproportionately larger decrease in OPR, though all groups had a lower OPR at the end of the study. Conclusions: The OPR decrease in late- and post-pandemic stages may be due to the pandemic. Though OPR differences existed between some rural/urban statuses and the ordering department pre-pandemic, these factors may have worsened these gaps. Future studies are needed to identify and address barriers to pediatric cholesterol screening.
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