ArticleBMJ open2026
Inequities in primary care respiratory illness presentations in Aotearoa (New Zealand) before, during and after the COVID-19 pandemic: a retrospective cohort study using automated health record analysis.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEthnic and socioeconomic inequities in respiratory illness outcomes are well established. Monitoring primary care presentation rates is important for assessing health system equitable responsiveness, particularly during health crises.
aimTo examine changes in primary care respiratory illness presentation rates in Aotearoa New Zealand (NZ) by ethnicity and socioeconomic status before, during and after the COVID-19 pandemic. DESIGN AND
settingRetrospective cohort study using natural language processing (NLP) of electronic health records from 37 general practices across eight districts in NZ.
methodClinical interactions from 2018 to 2023 (n=10 421 399; 4 66 349 patients) were classified into respiratory categories using a validated NLP algorithm. Age-adjusted monthly presentation rates were analysed by ethnicity and deprivation across pre-pandemic, pandemic and post-pandemic periods.
resultsOverall, 15.1% (1 573 631/10 421 399) of interactions were respiratory-related, increasing from 13.7% to 14.2% in 2018-2019 to a peak of 25.2% in 2022, before declining to 15.3% in 2023. Pacific peoples had higher presentation rates than European patients both pre-pandemic (+2.2, p=0.03) and during the pandemic (+3.5, p<0.01), and the presentation rates for Pacific peoples more than doubled during the pandemic peak. Post-pandemic, rates declined across all groups with larger reductions for Pacific peoples. Higher presentation rates were consistently observed among those in the most deprived quintile. Acute respiratory presentations varied more over time, while chronic conditions remained relatively stable.
conclusionsPrimary care presentation rates increased during the pandemic, particularly among high-needs populations, suggesting responsiveness to need. Post-pandemic declines in acute presentations, especially among Pacific peoples, may indicate emerging access barriers and widening inequities. NLP applied to routinely collected electronic health record data provides a retrospective approach to analysing primary care presentations and may support future development of surveillance approaches for monitoring equity trends.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.