Childhood asthma hospitalizations in the United States, 2000-2009

Area of Science:

• Pediatric Pulmonology
• Health Services Research
• Epidemiology

Background:

• Childhood asthma remains a significant public health concern in the United States.
• Understanding trends in pediatric asthma hospitalization, mortality, and treatment costs is crucial for resource allocation and healthcare policy.
• Previous research has indicated variability in asthma management outcomes over time.

Purpose of the Study:

• To analyze temporal trends in US childhood asthma hospitalizations, in-hospital mortality, mechanical ventilation use, and associated hospital charges.
• To identify changes in key pediatric asthma care indicators between 2000 and 2009.

Main Methods:

• A serial, cross-sectional analysis was conducted using the nationally representative Kids Inpatient Database (KID).
• Children aged under 18 years with asthma (ICD-9-CM code 493.xx) were identified.
• Outcome measures included asthma hospitalization incidence, in-hospital mortality, mechanical ventilation use, and hospital charges, adjusted for inflation.

Main Results:

• The rate of asthma hospitalizations in US children decreased by 13% from 2000 to 2009 (21.1 to 18.4 per 10,000 person-years).
• In-hospital mortality significantly declined (OR 0.37 for 2009 vs. 2000).
• Conversely, mechanical ventilation use increased by 28% (0.8% to 1.0%), and total hospital charges rose by 26% ($1.27 billion to $1.59 billion), driven by higher per-discharge costs.

Conclusions:

• Significant reductions in childhood asthma hospitalizations and in-hospital mortality were observed in the US between 2000 and 2009.
• Despite improved outcomes, there was a concurrent increase in the utilization of mechanical ventilation and escalating hospital charges for pediatric asthma care.
• These findings highlight a complex trend in pediatric asthma management, with progress in some areas but rising costs and resource intensity in others.