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Changing patterns of asthma hospitalization among children: 1979 to 1987
1Division of Health Examination Statistics, National Center for Health Statistics, Centers for Disease Control, Hyattsville, MD 20782.
Insights
Asthma hospitalizations in children significantly increased from 1979-1987, particularly in young children and Black children. This trend suggests factors beyond coding changes contributed to the rise in pediatric asthma admissions.
Area of Science:
- Pediatric Health
- Epidemiology
- Respiratory Medicine
Background:
- Asthma is a significant public health concern in children.
- Understanding hospitalization trends is crucial for resource allocation and intervention strategies.
Purpose of the Study:
- To analyze trends in asthma hospitalizations among children (0-17 years) in the United States from 1979 to 1987.
- To identify demographic variations in these hospitalization trends.
Main Methods:
- Utilized data from the National Hospital Discharge Survey (NHDS).
- Analyzed International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for asthma, bronchitis, and lower respiratory tract diseases.
- Calculated annual percentage changes and confidence intervals for hospitalization rates.
Main Results:
- Asthma hospitalizations among children aged 0-17 years increased by 4.5% annually.
- The increase was most pronounced in children aged 0-4 years (5.0% annually) and among Black children (1.8 times the increase seen in White children).
- Total hospitalizations decreased by 4.6% annually, and bronchitis hospitalizations decreased after 1983, suggesting coding shifts do not fully explain the asthma increase.
Conclusions:
- Pediatric asthma hospitalizations showed a significant upward trend during the study period.
- The rise in asthma hospitalizations, especially in younger children and minority groups, warrants further investigation into underlying causes.
- Coding changes alone do not account for the observed increase in pediatric asthma admissions.
Abstract:
The National Hospital Discharge Survey was used to evaluate the trends in asthma hospitalizations among children under International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): 1979 to 1987. During this period, asthma hospitalizations among children aged 0 to 17 years increased 4.5% per annum (95% confidence interval [Cl], 2% to 7.1%). The increase was largest among 0 to 4 year olds, 5.0% per annum (95% Cl, 3.4% to 6.7%), vs 2.9% per annum (95% Cl, -0.3% to 6.2%) observed among 5 to 17 year olds. Among children aged 0 to 4 years, blacks had approximately 1.8 times the increase of whites. During this time, total hospitalizations decreased -4.6% (95% Cl, -6.6% to -2.5%), while admissions for lower respiratory tract disease had a statistically insignificant decrease: -1.3%. Acute and chronic/unspecified bronchitis hospitalizations decreased -6.1% (95% Cl, -9.4% to -2.7%), but this decrease did not begin until 1983. Thus, a shift in coding from bronchitis to asthma does not seem to fully explain the increase.