A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods

BackgroundDuring the COVID-19 pandemic, there was a marked shift in the factors affecting health behaviors, suggesting a potential change in the rate of referrals to child development institutes during this period. To date, the rate of referrals to child development centers during the pandemic has n...

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Main Authors: Hallel Katsir, Michael Davidovitch, Michal Elboim-Gabyzon
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1447000/full
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author Hallel Katsir
Michael Davidovitch
Michal Elboim-Gabyzon
author_facet Hallel Katsir
Michael Davidovitch
Michal Elboim-Gabyzon
author_sort Hallel Katsir
collection DOAJ
description BackgroundDuring the COVID-19 pandemic, there was a marked shift in the factors affecting health behaviors, suggesting a potential change in the rate of referrals to child development institutes during this period. To date, the rate of referrals to child development centers during the pandemic has not been thoroughly examined.ObjectiveTo examined the difference in the annual and monthly referral and treatment patterns at child development institutes in the year 2020 (corona lockdown year) compared to the referrals in the year 2018–2019 (pre-corona period).MethodsThis retrospective cohort study analyzed data from the medical records of applicants to nine Child Development Institutes operated by the second-largest health fund in Israel (Maccabi Health Services). Descriptive statistics (medians and IQR for continuous variables, frequencies and percentages for categorical variables) were calculated for the pre-COVID period (2018–2019) vs. the COVID-closure year (2020). Inferential analyses used chi-square or Fisher’s exact tests for categorical outcomes and Mann–Whitney tests for continuous outcomes.ResultsDuring the COVID-19 closure period in 2020, there was a slight decrease (2.77%) in the annual number of referrals compared to the average of the preceding years 2018–2019 (13,143 inquiries and 13,518 inquiries, respectively). This decrease occurred primarily during the first lockdown period (March–May, 2020). The percentage distribution of annual diagnoses across various healthcare professionals was consistent across all periods examined. Notably, a substantial increase in the percentage of remote treatments was observed during the closure period compared to the pre-COVID era. Differences emerged in the demographic and social characteristics of the applicants during the closure period, such as their socioeconomic status and age.ConclusionCOVID-19 closures altered referral patterns to child development centers in both volume and applicant characteristics. Caregiver concerns about infection risk reduced in-person visits; restrictions changed clinic accessibility and drove rapid telehealth adoption; and staffing reassignments modified referral protocols. As a result, initial referrals declined, remote treatments increased, and applicant profiles skewed younger with shifts in socioeconomic and insurance status. To maintain continuity during future disruptions, hybrid delivery models, robust telehealth infrastructure, and streamlined appointment processes are essential. These insights can also inform prevention programs, policy planning, and resource allocation during public health crises.
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spelling doaj-art-5b532b0e27ff4b4b8a8217639c8556502025-08-20T03:27:31ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.14470001447000A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periodsHallel Katsir0Michael Davidovitch1Michal Elboim-Gabyzon2Department of Physical Therapy, Faculty of Welfare and Health Science, Haifa University, Haifa, IsraelChild Development, Medical Division, Maccabi Healthcare Services, Zichron-Yaakov, IsraelDepartment of Physical Therapy, Faculty of Welfare and Health Science, Haifa University, Haifa, IsraelBackgroundDuring the COVID-19 pandemic, there was a marked shift in the factors affecting health behaviors, suggesting a potential change in the rate of referrals to child development institutes during this period. To date, the rate of referrals to child development centers during the pandemic has not been thoroughly examined.ObjectiveTo examined the difference in the annual and monthly referral and treatment patterns at child development institutes in the year 2020 (corona lockdown year) compared to the referrals in the year 2018–2019 (pre-corona period).MethodsThis retrospective cohort study analyzed data from the medical records of applicants to nine Child Development Institutes operated by the second-largest health fund in Israel (Maccabi Health Services). Descriptive statistics (medians and IQR for continuous variables, frequencies and percentages for categorical variables) were calculated for the pre-COVID period (2018–2019) vs. the COVID-closure year (2020). Inferential analyses used chi-square or Fisher’s exact tests for categorical outcomes and Mann–Whitney tests for continuous outcomes.ResultsDuring the COVID-19 closure period in 2020, there was a slight decrease (2.77%) in the annual number of referrals compared to the average of the preceding years 2018–2019 (13,143 inquiries and 13,518 inquiries, respectively). This decrease occurred primarily during the first lockdown period (March–May, 2020). The percentage distribution of annual diagnoses across various healthcare professionals was consistent across all periods examined. Notably, a substantial increase in the percentage of remote treatments was observed during the closure period compared to the pre-COVID era. Differences emerged in the demographic and social characteristics of the applicants during the closure period, such as their socioeconomic status and age.ConclusionCOVID-19 closures altered referral patterns to child development centers in both volume and applicant characteristics. Caregiver concerns about infection risk reduced in-person visits; restrictions changed clinic accessibility and drove rapid telehealth adoption; and staffing reassignments modified referral protocols. As a result, initial referrals declined, remote treatments increased, and applicant profiles skewed younger with shifts in socioeconomic and insurance status. To maintain continuity during future disruptions, hybrid delivery models, robust telehealth infrastructure, and streamlined appointment processes are essential. These insights can also inform prevention programs, policy planning, and resource allocation during public health crises.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1447000/fullreferraltreatmentchild developmentcoronaclosure
spellingShingle Hallel Katsir
Michael Davidovitch
Michal Elboim-Gabyzon
A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
Frontiers in Public Health
referral
treatment
child development
corona
closure
title A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
title_full A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
title_fullStr A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
title_full_unstemmed A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
title_short A comparison of referral and treatment patterns at child development institutes during the corona closures and pre-corona periods
title_sort comparison of referral and treatment patterns at child development institutes during the corona closures and pre corona periods
topic referral
treatment
child development
corona
closure
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1447000/full
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