Rates of hospitalizations of children with asthma

Abstract

— Robert W. Wilmott, MD In this issue ofThe Journal, Hasegawa et al, fromHarvardMedical School and theClinical Epidemiology Center of St Luke’s Life Science Institute, have completed a temporal analysis of trends in hospital mortality, mechanical ventilator use, hospital charges, and childhood asthma hospitalizations in the US between 2000 and 2009. These data were generated from the “Kids Inpatient Database,” and the subjects were <18 years of age with asthma. Four years were analyzed: 2000, 2003, 2006 and 2009. The results showed that asthmahospitalizations decreased significantly, andmortality also declined significantly after adjusting for confounders. There was an increase inmechanical ventilation use over this time periodwhichmight reflect amore aggressive approach tomanagement of status asthmaticus in children. Nationwide, hospital charges increased by 26%, which was driven by a rise in the hospital charges per discharge. The results of this study suggest that there has been progress in reducing the impact of severe acute asthma in children in the US. However, mechanical ventilation and hospital charges for asthma hospitalizations have increased markedly. This increase might reflect improved management of sicker patients, yet the large asthma burden presents an ongoing public health and health education challenge. Article page 1127<