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Spatial and Temporal Patterns in Childhood and Adolescent Asthma Hospitalisations in Queensland, Australia: A 20-Year
Jialu Wang1,2, Javier Cortes-Ramirez1,3, Janet Davies1,2,4
1Queensland University of Technology, Brisbane, Queensland, Australia.
Objectives:
To examine spatial, temporal and seasonal patterns in childhood and adolescent asthma hospitalisations across Queensland, and assess variation in hospitalisation risk by age and sex across climate regions.
Design:
A retrospective, population-based ecological study using area-level administrative data from hospital admissions.
Setting:
All public and private hospitals in Queensland, Australia, 1 January 2000-31 December 2019.
Participants:
Children and adolescents aged 0-19 years who were admitted to hospital with a principal diagnosis of asthma.
Main Outcome Measures:
Age-standardised admission rates and relative risks (RRs) from spatial models; temporal patterns from time-series analysis; spatial variation from mapping; age-, sex- and climate zone-specific risks.
Results:
Hospitalisations among children aged 0-4 years declined from 48.1% (1640 admissions) in 2000 to 23.2% (721 admissions) in 2019, whereas proportions in older age groups increased. Seasonal peaks occurred in May, June and February, with male patients showing a stronger February peak and female patients maintaining higher risks into July. Hot desert regions had the highest RRs, rising from 3.73 (95% credible interval [CrI], 3.71-3.74) in 2000-2001 to 9.37 (95% CrI, 9.28-9.47) in 2009-2010, then declining to 2.37 (95% CrI, 2.37-2.38) in 2018-2019. Hot semi-arid and tropical savanna regions showed persistently elevated risks (hot semi-arid: RR, 1.86-3.75; tropical savanna: RR, 1.81-4.58). Three temporal phases were evident statewide: an early lower-risk period (2000-2002), a higher-risk period (2002-2012) and a later reduction (2012-2019), with most RRs between 0.5 and 1.5. Seasonality was strongest in hot desert zones (seasonal strength, 0.519) and weakest in tropical savanna zones (0.063).
Conclusions:
Childhood and adolescent asthma hospitalisations in Queensland exhibit significant spatiotemporal variation, with burden shifting from younger to older children, and climate-specific risks, although observed reductions in the youngest age group may partly reflect diagnostic and hospital admission practice changes. Higher asthma risks in arid and tropical savanna regions underscore the need for geographically tailored services and planning. These findings suggest that targeted public health strategies might help reduce asthma burden in vulnerable communities.
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