Fig 1.
Study period and social restrictions timeline.
Including marks of the three lockdowns imposed in Israel during the COVID-19 pandemic.
Table 1.
Patient and visit characteristics.
Table 2.
Patient and visit characteristics, compared between social restriction periods.
Fig 2.
Patient adherence rates (%) across time (monthly).
Includes marks of beginning and end of social restrictions period (dotted green lines) and the three lockdown periods (grey). Adherence to laboratory test referrals showed sporadic drops once social restrictions started. Adherence dropped for CBC, CRP, and throat culture. Adherence to penicillin and cephalosporins dropped during the second lockdown but increased after social restrictions. Adherence to macrolides increased during the first lockdown but dropped during the next lockdowns.
Table 3.
Adjusted odds ratios for time-period effect on patient adherencea.
Fig 3.
Heatmap of adjusted odds ratios (aOR) with 95% confidence intervals (CI) for patient adherence, relative to the period before social restrictions.
Adjusted odds ratios are presented on a log scale, centered at zero. Red indicates a decrease, while green indicates an increase. aOR were estimated by multivariate generalized linear mixed effects models with the binomial family and logit link. A. aOR during each lockdown and after social restrictions, relative to the period before the restrictions, adjusted for gender, age, clinic sector, visit type, diagnosis, and season at visit (see also Table 3). B-C. aOR during and after social restrictions, stratified by age (B) and by diagnosis (C), calculated based on the interaction effect with period, with adjustment for all other covariates. D. aOR for rural and Bedouin clinics, relative to urban clinics (left panel) and for telehealth visits (by phone call), relative to in-person visits. Full models’ results are provided in Supplementary S1 and S2 Tables, including regression coefficients, aOR and 95% CI.
Fig 4.
Patient adherence rates (%) across time (monthly) for the youngest and oldest age groups.
For chest X-ray, adherence decreased during social restrictions for patients aged 60 years or older and decreased after social restrictions for patients aged 0-3 years. For CBC referrals, adherence decreased during the first lockdown for patients of ages 0-3. For penicillin prescription, adherence decreased during social restrictions and increased afterwards for children aged 0-3. Opposite trends were observed for macrolides.