This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Russo, M. J.
Right arrow Articles by Roghmann, K. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Russo, M. J.
Right arrow Articles by Roghmann, K. J.
Related Collections
Right arrow Respiratory Tract

PEDIATRICS Vol. 104 No. 3 September 1999, pp. 454-462

Increase in Admission Threshold Explains Stable Asthma Hospitalization Rates

Received Sep 14, 1998; accepted Jan 26, 1999.

Mark J. Russo*, Kenneth M. McConnochieDagger , John T. McBrideDagger , Peter G. SzilagyiDagger , Ann Marie BrooksDagger , and Klaus J. RoghmannDagger

From the * Albert Einstein College of Medicine, Bronx, New York; and the Dagger  Department of Pediatrics, University of Rochester School of Medicine, Rochester, New York.

Background.  Asthma morbidity and mortality has increased substantially in recent years, but asthma hospitalization rates among many geographic and sociodemographic groups have remained stable. Observations on asthma hospitalization rates and severity of acute episodes might provide valuable insight into the functioning of the health care system during this period of health care reform.

Objective.  To analyze changes between 1991 and 1995 in childhood asthma hospitalization rates and severity of acute episodes.

Design and Methods.  All 29 329 hospitalizations, including 2028 for asthma, for the 198 893 children (<19 years of age) in Monroe County (Rochester), New York, were studied during this 5-year period. Severity was determined by hospital record review on a 22% random sample. Using the worst oxygen saturation (SaO2) during the first 24 hours of hospitalization as the primary index of severity, episodes were categorized as mild (0 to >= 95), moderate (90 to 94), or severe (<90).

Results.  Hospitalization rates are expressed as hospitalizations per 1000 child-years. The overall asthma hospitalization rate was 2.04 (95% confidence interval, 1.95-2.13). The overall annual asthma hospitalization rate remained relatively stable from 1991 (1.90) to 1995 (2.31), whereas the hospitalization rates for severe asthma rose 270%---from 0.57 to 1.55---during this period. Simultaneously, the hospitalization rates for mild asthma decreased from 0.26 to 0.12. As a proportion of all asthma hospitalizations between 1991 and 1995, severe episodes increased from 31.5% to 60.4%; conversely, mild episodes decreased from 14.1% to 4.7%.

Conclusions.  Severity increased significantly among children hospitalized for asthma while the overall asthma hospitalization rate remained stable. It seems that the health care system in this community has responded to an increase in severity of asthma by raising the severity threshold for admission.  Key words:  asthma, secular variation, hospitalization, children, severity, outcomes, oxygen saturation.




This article has been cited by other articles:


Home page
 ChestHome page
E. T. Naureckas, V. Dukic, X. Bao, and P. Rathouz
Short-Acting {beta}-Agonist Prescription Fills as a Marker for Asthma Morbidity
Chest, August 1, 2005; 128(2): 602 - 608.
[Abstract] [Full Text] [PDF]

Home page
 Psychiatr. Serv.Home page
D. S. Mandell, W. W. Thompson, E. S. Weintraub, F. DeStefano, and M. B. Blank
Trends in Diagnosis Rates for Autism and ADHD at Hospital Discharge in the Context of Other Psychiatric Diagnoses
Psychiatr Serv, January 1, 2005; 56(1): 56 - 62.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. J. Akinbami and K. C. Schoendorf
Trends in Childhood Asthma: Prevalence, Health Care Utilization, and Mortality
Pediatrics, August 1, 2002; 110(2): 315 - 322.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
D S Morrison and P McLoone
Changing patterns of hospital admission for asthma, 1981-97
Thorax, September 1, 2001; 56(9): 687 - 690.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
H. Bauchner, R. Vinci, and J. Chessare
Milliman and Robertson---Going in the Wrong Direction
Pediatrics, April 1, 2000; 105(4): 858 - 859.
[Full Text]

Home page
 Arch Pediatr Adolesc MedHome page
J. R. Meurer, V. George, S. Subichin, J. Yauck, and P. Layde
Asthma Severity Among Children Hospitalized in 1990 and 1995
Arch Pediatr Adolesc Med, February 1, 2000; 154(2): 143 - 149.
[Abstract] [Full Text] [PDF]