Corticosteroid therapy and need for hospital care in wheezing preschool children
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P Csonka1, J Mertsola, T Klaukka
1University of Tampere, Medical School, P.O. Box 607, FIN-33101 Tampere, Finland. peter.csonka@uta.fi
Insights
Frequent corticosteroid use in preschool children with wheezing was linked to fewer hospital admissions. This study found significant regional differences in treatment approaches and inpatient care across Finland.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacy
- Health Services Research
Background:
- Wheezing is a common respiratory symptom in preschool children, often managed with corticosteroids.
- Significant regional variations in healthcare practices can impact treatment outcomes and resource utilization.
Purpose of the Study:
- To investigate the frequency of corticosteroid therapy and inpatient care for preschool children experiencing wheezing in two Finnish regions.
- To identify potential associations between corticosteroid use and hospitalization rates.
Main Methods:
- Retrospective analysis of hospital records for 800 children (0.5-6.9 years) treated for wheezing between 1995-1996 in Tampere and Turku, Finland.
- Utilized data from the Finnish Social Insurance Institution on refundable asthma medication use.
Main Results:
- Incidences of wheezing-related emergency room visits were similar in both regions (11.0/year/1000 children).
- Marked regional differences observed in oral corticosteroid administration (ER: 2.5% vs 24.2%; ward: 10.6% vs 89.7%) and hospitalization rates (44.8% vs 36.8%).
- Children with prior inhaled corticosteroid therapy required less inpatient care, with shorter hospital stays in Turku (1.4 days) compared to Tampere (3.4 days).
Conclusions:
- Significant regional disparities exist in the management of preschool wheezing.
- Population-level data suggests that increased corticosteroid therapy is associated with decreased hospital admissions for wheezing children.
Objectives:
To study the frequency of corticosteroid therapy and the use of inpatient care for preschool children with wheezing in two regions in Finland.
Methods:
The Finnish Social Insurance Institution database on refundable asthma medication indicated that 1.18% of children in Tampere and 2.37% in Turku used inhaled corticosteroids regularly. To clarify the difference, hospital records of 800 randomly chosen 0.5-6.9-year-old children who had been treated for wheezing in Tampere or Turku University Hospital during 1995-1996 were retrospectively analysed.
Results:
The incidences of wheezing-related emergency room (ER) index visits were 11.0 visits/year/1000 children both in Tampere and Turku. Oral corticosteroids were given to 2.5% versus 24.2% of children in ER and 10.6% versus 89.7% in hospital ward in Tampere and Turku, respectively. Hospitalisation rates were 44.8% in Tampere and 36.8% in Turku (95% confidence interval for the difference 1.2-14.8%). In both regions, children with prior inhaled corticosteroid therapy needed less inpatient care. Mean duration of hospitalisation was 3.4 days in Tampere and only 1.4 days in Turku. Recurrent visits in 6 months were more common in Tampere.
Conclusions:
There were marked regional differences in the management of preschool children with wheezing. On a population level, frequent use of corticosteroid therapy was associated with reduced hospital admissions.
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