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Regional differences in pediatric asthma hospital admissions: National data from Israel 1996-2017
Joel Reiter1,2, Isabella Karakis3, Itamar Grotto4
1Faculty of Medicine, Hebrew University of Jerusalem, Israel.
Insights
Pediatric asthma hospitalizations significantly decreased nationwide between 1996 and 2017, with notable regional variations in admission rates and decline trends. The greatest decline was observed in the Tel-Aviv district.
Area of Science:
- Pediatric Pulmonology
- Public Health Epidemiology
- Healthcare Management
Background:
- Asthma is a prevalent chronic illness in children, frequently leading to hospitalizations.
- While admission rates declined until the 1990s, recent trends have been less clear.
- Understanding current hospitalization patterns is crucial for public health initiatives.
Purpose of the Study:
- To analyze pediatric asthma admission rates and regional disparities over two decades.
- To identify trends in asthma hospitalizations across different Israeli districts.
- To assess the rate of decline in pediatric asthma admissions.
Main Methods:
- Retrospective cohort study of pediatric asthma admissions (ages 1-14) from 1996-2017.
- Utilized the national Ministry of Health database and National Hospital Discharge Registry.
- Calculated admission rates per 1000 age-adjusted residents.
Main Results:
- Annual asthma hospitalization rates declined from 2.14 (1996) to 0.89 (2017) per 1000 children.
- Children aged 1-4 years accounted for the majority of admissions and the largest decline.
- Significant regional differences in admission rates and decline rates were observed, with varying patterns across districts.
Conclusions:
- A nationwide decrease in pediatric asthma hospitalizations occurred over two decades.
- Clear regional disparities exist in both asthma admission rates and their rates of decline.
- Findings highlight the need for geographically tailored public health strategies for childhood asthma.
Background:
Asthma is a common chronic childhood illness and frequent cause of hospitalization. A decline in hospital admission rates was noted up to the 1990s, however, trends are not as clear since the turn of the century. This study aimed to assess the rates and regional differences of asthma admissions over more than two decades using the national Ministry of Health database, which registers data from all the hospitals.
Methods:
A retrospective cohort study, analysis of all pediatric asthma admissions, for Patients 1-14 years old, between 1996 and 2017 as recorded by the National Hospital Discharge Registry, was performed. Asthma admission rates were calculated per 1000 age adjusted residents, using the number of admission cases as the numerator, and age specific population size as the denominator.
Results:
The annual asthma hospitalization rate decreased in the entire pediatric population from 2.14 in 1996-0.89 in 2017. Children in the 1-4 year age group comprised most of the hospital admissions, and most of the decline was attributable to this age group. Significant differences in hospitalizations were found between different regions as well as differences in the rate of decline in asthma hospitalizations with the lowest admission rate in the Jerusalem district, highest in Haifa, northern and southern Israeli regions and the greatest rate of decline in the Tel-Aviv district.
Conclusion:
This nationwide study, over more than two decades, shows clear regional differences in the rates of asthma admissions as well as regional differences in the rates of decline.
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