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The High Burden of Asthma Readmission Among Australian Children: A Population-Based Cohort Study
Md Mahbubur Rashid1, Nan Hu1, Jahidur Rahman Khan1
1School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Insights
Asthma hospital readmissions are common in children, especially preschoolers, costing millions. Improving post-discharge care is crucial to reduce these readmissions and their economic impact.
Area of Science:
- Pediatric Respiratory Medicine
- Health Services Research
- Public Health
Background:
- Asthma hospitalizations represent a significant global health burden, with up to 40% being repeat admissions.
- Understanding asthma readmission rates in pediatric populations is critical for resource allocation and patient management.
Purpose of the Study:
- To estimate the incidence and economic burden of asthma readmissions in children aged 2 to 17 years in New South Wales (NSW), Australia.
- To identify high-risk age groups and socioeconomic factors associated with pediatric asthma readmissions.
Main Methods:
- A retrospective, population-based cohort study using linked administrative data from New South Wales (NSW).
- Inclusion criteria: Children aged 2-17 years with at least one asthma hospitalization between 2005 and 2015.
- Follow-up period: 12 months post-index asthma hospitalization to assess readmission rates and direct medical costs.
Main Results:
- Over 48,000 asthma hospitalizations were recorded; 28,177 index hospitalizations in children.
- 21.6% of children experienced first asthma readmissions within 12 months.
- The 2-4 year age group accounted for over 80% of readmissions, with a significant proportion from disadvantaged areas.
- Total direct medical costs for first readmissions within 12 months reached AU$15.6 million.
Conclusions:
- Preschool-aged children (2-4 years) exhibit the highest asthma readmission rates.
- Asthma readmissions impose a substantial economic burden on the healthcare system.
- Identifying modifiable factors, particularly post-discharge asthma management, is essential to mitigate pediatric asthma hospital readmissions.
Background And Objective:
Worldwide, up to 40% of all asthma hospitalisations are due to repeat admissions. This study aimed to estimate the burden of asthma readmission among children aged 2 to 17 years in New South Wales (NSW), Australia.
Methods:
A retrospective longitudinal whole-of-population-based cohort study was conducted using linked administrative data. Children born in NSW from 2005 to 2015 having at least one asthma hospitalisation after the age of 2 years were included in the study and followed up for 12 months from the asthma index hospitalisation. The incidence rates for asthma first readmission within 12 months and associated direct medical costs were calculated.
Results:
During 2007-2022, 48,217 asthma hospitalisations occurred in children, with 28,177 children hospitalised for asthma as a primary diagnosis identified as asthma index hospitalisations. Among them, 21.6% experienced first asthma readmissions within 12 months, including over 80% from the 2-4 years age group and a significant proportion from socioeconomically disadvantaged areas. The overall incidence rate of first asthma readmission was 23.8 per 100 person-years and 28.7 per 100 person-years for children aged 2-4 years. The highest incidence rate (38.3 per 1000 person-months) occurred within 1 month. The total direct medical cost of the first asthma readmission within 12 months was AU$ 15.6 million.
Conclusion:
Our study suggests that pre-school children have the highest rate of asthma readmission, with a significant economic burden highlighting the need for identifying modifiable factors such as asthma management after discharge to reduce the burden of asthma hospital readmission in children.
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