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Hospitalization of children for asthma varies according to the child's age and sex and several other factors

The number of childhood asthma cases and deaths increased during the past decade. During that time the proportion of children hospitalized for severe asthma (between 4 and 5 percent) didn't change much. Adolescents and boys were more likely to be hospitalized for severe asthma (respiratory distress or failure) than children aged 5 to 12 and girls, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS09564).

In addition to patient age and sex, region of the country and hospital teaching status were significantly associated with variation in the severity of asthma among hospitalized children. Hospitals in western, southern, and north-central regions of the country were more apt to care for a greater proportion of children with severe asthma than hospitals in the northeast. Also, urban teaching compared with nonteaching hospitals were more likely to care for a higher proportion of children with severe asthma.

Between 1990 and 1995, the median length of hospital stay decreased for children with low-severity asthma (accompanied by respiratory or middle ear infections) but remained the same for children with high-severity asthma (respiratory distress or failure). During the same period, inflation-adjusted median total charges did not change significantly for any severity class. These findings were based on analysis of national data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS).

Medical College of Wisconsin researchers, led by John R. Meurer, M.D., M.M., selected the discharge records of patients 18 years of age and younger who were hospitalized for asthma in 1990 or 1995. Using these criteria, Dr. Meurer and colleagues analyzed the discharge records of more than 168,000 children in 746 hospitals in 1990 and over 174,000 children in 811 hospitals in 1995. The researchers call for studies to estimate State-level asthma prevalence and hospitalization rates to provide more precise estimates of the burden of asthma among children and the frequency of hospital care.

More details are in "Asthma severity among children hospitalized in 1990 and 1995," by Dr. Meurer, Varghese George, Ph.D., Steve Subichin, M.S., M.B.A., and others, in the February 2000 Archives of Pediatric and Adolescent Medicine 154, pp. 143-149.

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