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.

Publication date: Jun 25, 2026

Ethnic 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. To 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. Retrospective cohort study using natural language processing (NLP) of electronic health records from 37 general practices across eight districts in NZ. Clinical 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. Overall, 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

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Concepts Keywords
Pandemic COVID-19
Patients Primary Care
Zealand Vulnerable Populations

Semantics

Type Source Name
disease MESH COVID-19 pandemic

Original Article

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