P4.054: To assess the pandemic-related differences in the prevalence of diagnosed genetic conditions (GC) in children (0-17 years) and their healthcare access and utilization in the United States

Background: The COVID-19 pandemic disrupted healthcare delivery worldwide, potentially affecting vulnerable populations like children with genetic conditions more severely. Prior research has shown that children with genetic conditions typically require more frequent healthcare visits and face higher rates of unmet health needs compared to children without genetic conditions. However, limited data exists on how the pandemic specifically impacted healthcare access and utilization patterns for this population. Using data from the National Survey of Children's Health (2016-2022), this study examined pandemic-related changes in the prevalence of diagnosed genetic conditions and associated healthcare utilization patterns.

Methods: Using the National Survey of Children's Health (NSCH) data, we compared pre-pandemic (2016-2019) and pandemic (2020-2022) prevalence estimates for diagnosed GC, healthcare utilization (HCU), and unmet health needs (UHN). The prevalence ratios (PR) of HCU and UHN during versus pre-pandemic for different groups were compared using interaction models, adjusted for age, sex, socioeconomic status, and race-ethnicity.

Results: Pre-pandemic, GC prevalence was 4.09% rising to 4.95% during the pandemic [PR = 1.21 (1.126, 1.3), p < 0.001]. Pre-pandemic, children with GC had higher HCU [PR = 1.143 (1.123, 1.162), p < 0.001] and UHN [PR = 2.391 (1.971, 2.902), p < 0.001] as compared to children without GC. For children with GC, there was a decrease in HCU [PR = 0.962 (0.939, 0.985), p = 0.002], however, UHN was similar [PR = 1.219 (0.967, 1.535), p = 0.093] during versus pre-pandemic.

Conclusion: The prevalence of diagnosed GC increased and disparities in UHN for children with GC persisted during the pandemic.