Hospital Admissions For Asthma Research Articles

Patterns of asthma medication use and hospital discharges in New Zealand

In New Zealand a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in dispensing of short-acting β2-agonists (SABAs), inhaled corticosteroids (ICSs), and other ICS/long-acting β2-agonists (ICSs/LABAs), occurred in the 18-month period following publication of the 2020 New Zealand asthma guidelines, which recommended budesonide/formoterol anti-inflammatory reliever therapy. Our aim was to investigate more recent trends in asthma medication use and asthma hospital discharges in New Zealand. New Zealand national dispensing data for inhalers for the period from January 2010 to December 2022 were reviewed for patients aged 12 years and older. Monthly rates of dispensing of budesonide/formoterol, ICSs, other ICS/LABAs, and SABAs were displayed graphically by locally weighted scatterplot smoother plots. The rates of dispensing and hospital discharge for asthma were compared between the past 6 months for which dispensing data were available (July-December 2022) and the corresponding period from July to December 2019. There has been a progressive increase in dispensing of budesonide/formoterol since 2019, with a 108% increase between the period from July to December 2019 and the period from July to December 2022 in adolescents and adults. In contrast, there was a reduction in rates of dispensing of other ICS/LABAs, ICSs, and SABAs by 3%, 18%, and 5%, respectively. During this period, there was a 17% reduction in hospital discharges for asthma. There has been a further widespread uptake of ICS/formoterol reliever and/or maintenance therapy in adolescents and adults with asthma in New Zealand. The changes in prescribing practice have been temporally associated with a reduction in hospital admissions for asthma.

Short-Term Nitrogen Dioxide Exposure and Emergency Hospital Admissions for Asthma in Children: A Case-Crossover Analysis in England.

There is an increasing body of evidence associating short-term ambient nitrogen dioxide (NO2) exposure with asthma-related hospital admissions in children. However, most studies have relied on temporally resolved exposure information, potentially ignoring the spatial variability of NO2. We aimed to investigate how daily NO2 estimates from a highly resolved spatio-temporal model are associated with the risk of emergency hospital admission for asthma in children in England. We conducted a time-stratified case-crossover study including 111,766 emergency hospital admissions for asthma in children (aged 0-14 years) between 1st January 2011 and 31st December 2015 in England. Daily NO2 levels were predicted at the patients' place of residence using spatio-temporal models by combining land use data and chemical transport model estimates. Conditional logistic regression models were used to obtain the odds ratios (OR) and confidence intervals (CI) after adjusting for temperature, relative humidity, bank holidays, and influenza rates. The effect modifications by age, sex, season, area-level income deprivation, and region were explored in stratified analyses. For each 10 µg/m³ increase in NO2 exposure, we observed an 8% increase in asthma-related emergency admissions using a five-day moving NO2 average (mean lag 0-4) (OR 1.08, 95% CI 1.06-1.10). In the stratified analysis, we found larger effect sizes for male (OR 1.10, 95% CI 1.07-1.12) and during the cold season (OR 1.10, 95% CI 1.08-1.12). The effect estimates varied slightly by age group, area-level income deprivation, and region. Short-term exposure to NO2 was significantly associated with an increased risk of asthma emergency admissions among children in England. Future guidance and policies need to consider reflecting certain proven modifications, such as using season-specific countermeasures for air pollution control, to protect the at-risk population.

Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China.

This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution. We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach. The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively. This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.

Impacts of ambient air quality on acute asthma hospital admissions during the COVID-19 pandemic in Oxford City, UK: a time-series study

ObjectivesThe study aims to investigate the short-term associations between exposure to ambient air pollution (nitrogen dioxide (NO2), particulate matter pollution—particles with diameter<2.5 µm (PM2.5) and PM10) and incidence of asthma...

The influence of social and environmental determinants of health on hospitalizations for pediatric asthma

Background Asthma is the most common chronic disease of childhood, and has several social, environmental, and demographic factors potentially influential to its disease burden. This study sought to determine the influence of these factors on hospital admissions and readmissions for pediatric asthma. Methods This was a retrospective cohort study using data from the Indiana Network for Patient Care, a state-wide health information exchange in the United States. Study participants were children 2-18 years old admitted to the hospital with a respiratory diagnostic code between 2010 and 2021. Clinical variables were obtained from electronic health record data, and social and environmental determinants of health data were obtained from the Indiana Social Assets and Vulnerabilities Indicators using geocoding systems. Negative binomial models were used to examine community level social and environmental risk factors modifying the relationship between patient characteristics and the risk of asthma-related hospitalizations and 30-day readmissions. Results The study sample included 25,063 patients with an average follow-up of 9 (SD = 5) years. Of these, there were 17,816 asthma-related admissions. There were a total of 1,037 asthma-related 30-day readmissions, with an incidence rate of readmissions relative to total visits of 0.028 per person-year. A high social vulnerability index (SVI) was associated with an increased rate of hospital admissions (Proportion attributable ratio: 1.09, 95%CI (1.03,1.15), p < 0.05). No environmental determinants of health were significantly associated with hospitalization rate. Conclusion High SVI was significantly associated with increased risk of total hospital admissions for pediatric asthma.

Relationship between air quality and asthma-related emergency hospital admissions in Mexico City 2017–2019

BackgroundPrevious studies found exposure to air pollution leads to exacerbations of asthma in paediatric and adult patients and increases asthma-related emergency hospital admissions (AREHA).MethodsAREHAs and levels of air pollutants (PM10,...

Post-hospitalisation asthma management in primary care: a retrospective cohort study.

Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge. To evaluate asthma management in primary care following a hospital admission for asthma and its associations with patient characteristics. A retrospective cohort study using English primary care data from the Clinical Practice Research Datalink Aurum database and linked Hospital Episode Statistics Admitted Patient Care data. Patients with asthma aged ≥5 years who had at least one asthma-related hospital admission from 1 January 2017 to 31 December 2019 were included. The primary outcome was a composite of any of the following delivered in primary care within 28 days from hospital discharge: asthma review, asthma management plan, asthma medication prescriptions, demonstration of inhaler technique, or smoking cessation counselling. The association between patient characteristics and delivery of clinical care was assessed using logistic regression. The study included 17 457 patients. A total of 10 515 (60.2%) patients received the primary outcome within 28 days of hospital discharge. There were 2311 (13.2%) who received an asthma review, 1459 (8.4%) an asthma management plan, 9996 (57.3%) an asthma medication, 1500 (8.6%) a demonstration of inhaler technique, and 52 (1.2% of smokers) had smoking cessation counselling. Patients from Black ethnic minority groups received less of this care (27%- 54% lower odds, depending on age). However, short-acting bronchodilator prescriptions in the previous year were associated with an increased likelihood of the primary outcome. A significant proportion of patients do not receive timely follow-up in primary care following asthma-related admissions to hospital, particularly among Black ethnic minority groups.

Prevalence of Poorly Controlled Asthma and Factors Associated with Specialist Referral in Those with Poorly Controlled Asthma in a Paediatric Asthma Population.

Significant morbidity and mortality are associated with poor asthma control. The aim of this study was to determine factors associated with poor control and referral to specialist secondary care services. We used primary care data from the Clinical Practice Research Datalink Aurum (CPRD) linked with Hospital Episode Statistics (HES) records from 1st January 2007 to 31st December 2019. We selected patients aged 6-17 years old. Poor control was defined as six or more prescriptions of short-acting beta-agonist (SABA) inhalers, two or more courses of oral corticosteroids (OCS), an Asthma Control test (ACT) or childhood ACT <20, one hospital admission for asthma, or one visit to Accident & Emergency (A&E) department for asthma-related episodes in the 12 months following asthma diagnosis. Asthma severity was defined following GINA guidelines 2021. About 17.6% of children aged between 6 and 17 years with active asthma had poor control. Severe asthma, eczema, food allergies, increased BMI and living in deprived areas were identified as risk factors for poor control. Among those with poor control, referral rates to specialist care were extremely low, only 2% overall. Those with severe asthma were three-times more likely to be referred than those with mild-to-moderate asthma [HRcrude = 4.04 (95% CI, 3.35-4.87); HRadj = 2.72 (95% CI: 2.13-3.49)]. Other factors associated with referral were food allergy and living in a more deprived area. Around 1 in 6 children and adolescents with active asthma are not achieving adequate control of their symptoms. Among the subset of 6-17-year olds with poorly controlled asthma, timely referral for specialist advice in secondary care is rare, especially in those with so-called mild asthma who nevertheless are at significant risk for poor asthma outcomes.

Regional heterogeneity in short-term associations of meteorological factors, air pollution, and asthma hospitalizations in Guangxi, China

ObjectivesThis study aimed to identify and evaluate the short-term and lag effects of environmental factors on asthma hospitalizations in different regions. Study designThe ecological study on asthma is performed in three regions of Guangxi, China, that are distinctly different in geography and climate. MethodsWe used distributed lag non-linear models to investigate the exposure-response-lag relationship between meteorological factors, air pollutants, and asthma hospital admissions across the three regions during 2015 (January 1 to December 31). ResultsCold was an important meteorological factor affecting asthma. At lag 0, the relative risk (RR; 23°C as reference) of cold in the Northwest, Northeast, and South was 1.10 (10°C), 1.14 (8°C), and 1.30 (11°C), respectively. NO2 was identified as the most important air pollutant affecting asthma. The RR of asthma hospitalization increased by 10.9% (at lag 4), 8.1% (at lag 0), and 4.2% (at lag 2) for every 10 μg/m3 increase in NO2 concentration in the Northwest, Northeast, and South, respectively. ConclusionsIn the three regions of Guangxi, there were differences in the dominant factors affecting asthma hospitalizations. Differences in geography can inform governments as to how to prepare the healthcare system to meet the expected peaks.

Short-term exposure to ultrafine particles and mortality and hospital admissions due to respiratory and cardiovascular diseases in Copenhagen, Denmark

Ultrafine particles (UFP; particulate matter <0.1 μm in diameter) may be more harmful to human health than larger particles, but epidemiological evidence on their health effects is still limited. In this study, we examined the association between short-term exposure to UFP and mortality and hospital admissions in Copenhagen, Denmark. Daily concentrations of UFP (measured as particle number concentration in a size range 11–700 nm) and meteorological variables were monitored at an urban background station in central Copenhagen during 2002–2018. Daily counts of deaths from all non-accidental causes, as well as deaths and hospital admissions from cardiovascular and respiratory diseases were obtained from Danish registers. Mortality and hospital admissions associated with an interquartile range (IQR) increase in UFP exposure on a concurrent day and up to six preceding days prior to the death or admission were examined in a case-crossover study design. Odds ratios (OR) with 95% confidence intervals (CI) per one IQR increase in UFP were estimated after adjusting for temperature and relative humidity. We observed 140,079 deaths in total, 236,003 respiratory and 342,074 cardiovascular hospital admissions between 2002 and 2018. Hospital admissions due to respiratory and cardiovascular diseases were significantly positively associated with one IQR increase in UFP (OR: 1.04 [95% CI: 1.01, 1.07], lag 0–4, and 1.02 [1.00, 1.04], lag 0–1, respectively). Among the specific causes, the strongest associations were found for chronic obstructive pulmonary disease (COPD) mortality and asthma hospital admissions and two-day means (lag 0–1) of UFP (OR: 1.13 [1.01, 1.26] and 1.08 [1.00, 1.16], respectively, per one IQR increase in UFP). Based on 17 years of UFP monitoring data, we present novel findings showing that short-term exposure to UFP can trigger respiratory and cardiovascular diseases mortality and morbidity in Copenhagen, Denmark. The strongest associations with UFP were observed with COPD mortality and asthma hospital admissions.

The prevalence of pediatric asthma hospitalizations at different stages of the COVID-19 pandemic: A systematic review and meta-analysis study protocol.

Asthma is a highly prevalent chronic inflammatory lung disease and is a frequent cause of hospitalization in children. The COVID-19 pandemic has introduced several challenges that have impacted the delivery of care for vulnerable patients, including asthmatic children. Asthmatic children without immediate access to healthcare services can face severe and fatal consequences. Furthermore, various governmental restrictions and viral mutants have been introduced throughout the pandemic, affecting COVID-19 cases and hospitalization rates. To investigate the impact of the COVID-19 pandemic on the prevalence of asthma hospitalizations during various stages of the pandemic. We also aim to compare asthma hospital admissions during the pandemic to pre-pandemic periods. The databases PubMed (MEDLINE), EMBASE, CINAHL, and the Cochrane library will be used to identify relevant articles between the start of the pandemic and the date of the search strategy. Studies will be included if they examine hospital admissions for pediatric (0 to 18 years) asthma patients, regardless of asthma severity, sex, ethnicity or race. Observational retrospective cohort, prospective cohort, and cross-sectional studies will be included. A meta-analysis will be conducted if there are ≥2 articles. Else, a narrative review will be used to report our results. PROSPERO registration number: CRD42022337606.

New concentration-response functions for seven morbidity endpoints associated with short-term PM2.5 exposure and their implications for health impact assessment

BackgroundMorbidity burdens from ambient air pollution are associated with market and non-market costs and are therefore important for policymaking. The estimation of morbidity burdens is based on concentration–response functions (CRFs). Most existing CRFs for short-term exposures to PM2.5 assume a fixed risk estimate as a log-linear function over an extrapolated exposure range, based on evidence primarily from Europe and North America. ObjectivesWe revisit these CRFs by performing a systematic review for seven morbidity endpoints previously assessed by the World Health Organization, including data from all available regions. These endpoints include all cardiovascular hospital admission, all respiratory hospital admission, asthma hospital admission and emergency room visit, along with the outcomes that stem from morbidity, such as lost work days, respiratory restricted activity days, and child bronchitis symptom days. MethodsWe estimate CRFs for each endpoint, using both a log-linear model and a nonlinear model that includes additional parameters to better fit evidence from high-exposure regions. We quantify uncertainties associated with these CRFs through randomization and Monte Carlo simulations. ResultsThe CRFs in this study show reduced model uncertainty compared with previous CRFs in all endpoints. The nonlinear CRFs produce more than doubled global estimates on average, depending on the endpoint. Overall, we assess that our CRFs can be used to provide policy analysis of air pollution impacts at the global scale. It is however important to note that improvement of CRFs requires observations over a wide range of conditions, and current available literature is still limited. DiscussionThe higher estimates produced by the nonlinear CRFs indicates the possibility of a large underestimation in current assessments of the morbidity impacts attributable to air pollution. Further studies should be pursued to better constrain the CRFs studied here, and to better characterize the causal relationship between exposures to PM2.5 and morbidity outcomes.

Maternal mental illness and child atopy: a UK population-based, primary care cohort study.

The number of children exposed to maternal mental illness is rapidly increasing and little is known about the effects of maternal mental illness on childhood atopy. To investigate the association between maternal mental illness and risk of atopy among offspring. Retrospective cohort study using a UK primary care database (674 general practices). In total, 590 778 children (born 1 January 1993 to 30 November 2017) were followed until their 18th birthday, with 359 611 linked to their hospital records. Time-varying exposure was captured for common (depression and anxiety), serious (psychosis), addiction (alcohol and substance misuse), and other (eating and personality disorder) maternal mental illness from 6 months before pregnancy. Using Cox regression models, incidence rates of atopy were calculated and compared for the exposed and unexposed children in primary (asthma, eczema, allergic rhinitis, and food allergies) and secondary (asthma and food allergies) care, adjusted for maternal (age, atopy history, smoking, and antibiotic use), child (sex, ethnicity, and birth year/season), and area covariates (deprivation and region). Children exposed to common maternal mental illness were at highest risk of developing asthma (adjusted hazard ratio [aHR] 1.17, 95% confidence interval [CI] = 1.15 to 1.20) and allergic rhinitis (aHR 1.17, 95% CI = 1.13 to 1.21), as well as a hospital admission for asthma (aHR 1.29, 95% CI = 1.20 to 1.38). Children exposed to addiction disorders were 9% less likely to develop eczema (aHR 0.91, 95% CI = 0.85 to 0.97) and 35% less likely to develop food allergies (aHR 0.65, 95% CI = 0.45 to 0.93). The finding that risk of atopy varies by type of maternal mental illness prompts important aetiological questions. The link between common mental illness and childhood atopy requires GPs and policymakers to act and support vulnerable women to access preventive (for example, smoking cessation) services earlier.

Extreme weather and asthma: a systematic review and meta-analysis.

Climate change's influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes. A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes. We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13-1.24), 1.10-fold for asthma symptoms (95% CI 1.03-1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00-1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14-1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04-1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06-1.34) and of asthma mortality of 2.10-fold (95% CI 1.35-3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08-1.32 and 95% CI 0.98-1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13-1.36). Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.

Acute paediatric asthma treatment in the prehospital setting: a retrospective observational study

ObjectivesTo describe the incidence of and patterns of ‘escalated care’ (care in addition to standard treatment with systemic corticosteroids and inhaled bronchodilators) for children receiving prehospital treatment for asthma.DesignRetrospective observational...

Spatial distribution of hospital admissions for asthma in the central area of Asturias, Northern Spain

BackgroundAsturias is one of the communities with the highest rates of hospital admission for asthma in Spain. The environmental pollution or people lifestyle are some of the factors that contribute to the appearance or aggravation of this illness. The aim of this study was to show the spatial distribution of asthma admissions risks in the central municipalities of Asturias and to analyze the observed spatial patterns.MethodsUrgent hospital admissions for asthma and status asthmaticus occurred between 2016 to 2018 on the public hospitals of the central area of Asturias were used. Population data were assigned in 5 age groups. Standardised admission ratio (SAR), smoothed relative risk (SRR) and posterior risk probability (PP) were calculated for each census tract (CT). A spatial trend analysis was run, a spatial autocorrelation index (Morans I) was calculated and a cluster and outlier analysis (Anselin Local Morans I) was finally performed in order to analyze spatial clusters.ResultsThe total number of hospital urgent asthma admissions during the study period was 2324, 1475 (63.46%) men and 849 (36.56%) women. The municipalities with the highest values of SRR and PP were located on the northwest area: Avilés, Gozón, Carreño, Corvera de Asturias, Castrillón and Illas. A high risk cluster was found for the municipalities of Avilés, Gozón y Corvera de Asturias.ConclusionsThe spatial analysis showed high risk of hospitalization for asthma on the municipalities of the northwest area of the study, which highlight the existence of spatial inequalities on the distribution of urgent hospital admissions.

The relationship between childhood asthma and socioeconomic status: a Korean nationwide population-based study.

This study aimed to investigate associations of socioeconomic status (SES) with asthma exacerbation and asthma-related hospital utilization factors among children with asthma in the Republic of Korea. This study retrospectively analyzed population-level data from the Korean National Health Insurance Service, collected from 2013 through 2019. SES was classified into five categories according to the national health insurance premiums quantiles (0 [lowest] to 4 [highest]). The hazard ratios (HRs) for asthma exacerbation, emergency department (ED) visits, hospital admission, and intensive care unit (ICU) admission were analyzed with respect to SES. Among the five SES groups, SES group 0 (medical aid), had the highest tallies and proportions of children who experienced asthma exacerbations (n = 1,682, 4.8%), ED visits (n = 932, 2.6%), hospital admission (n = 2,734, 7.7%) and ICU admission (n = 14, 0.04%). Compared with SES group 4, SES group 0 had adjusted HRs of 3.73 (p = 0.0113) and 1.04 (p < 0.0001) for ventilator support/tracheal intubation and administration of systemic corticosteroids, respectively. Relative to group 4, the adjusted HRs for ED visits, hospital admission, and ICU admission in group 0 were 1.88 (p < 0.0001), 2.20 (p < 0.0001), and 7.12 (p < 0.0001), respectively. In the survival analysis, group 0 had a significantly higher risk of ED presentation, hospital admission, and ICU admission than the other groups (log-rank p < 0.001). Compared with children of higher SES, those in the lowest SES group had increased risk of asthma exacerbation, hospital admission, and receiving treatment for severe asthma symptoms.

Asthma hospitalisations and heat exposure in England: a case–crossover study during 2002–2019

BackgroundPrevious studies have reported an association between warm temperature and asthma hospitalisation. They have reported different sex-related and age-related vulnerabilities; nevertheless, little is known about how this effect has changed...

Trends in hospital admissions among children with asthma in Spain (2011–2020)

The purpose of this study is to describe and assess changes in incidence, clinical conditions, use of mechanical ventilation, length of hospital stay (LOHS), and in-hospital mortality (IHM) among children hospitalized with asthma in Spain from 2011 to 2020. We analyzed children aged 0 to 15 years hospitalized with an ICD code for asthma included in the Spanish National Hospital Discharge Database (SNHDD). The analysis was conducted for asthma as the primary diagnosis and with asthma in any diagnosis position. Joinpoint regression was used to assess time trends in incidence. We included a total of 85,664 children hospitalized with asthma; of these, 46,727 (54.55%) had asthma coded as the primary diagnosis. The number of boys was higher than the number of girls, irrespective of age group or diagnostic position. The frequency of asthma as primary diagnosis decreased from 55.7% in 2011 to 43.96% in 2020 (p < 0.001). The incidence of hospitalizations because of asthma decreased significantly from 2011 to 2020, with a faster decrease from 2018 onwards. Over time, the proportion of older children increased. In the year 2020, only 55 children had codes for asthma and COVID-19 in their discharge report, and this infection had no effect on hospitalizations this year. A significant increase in the use of non-invasive ventilation (NIV) was observed over time. Irrespective of the diagnostic position, LOHS and IHM remained stable over time, with the IHM under 0.1%. Conclusion: Our results show a decrease in the incidence of hospital admissions with asthma either as the primary diagnosis or in any position. The age of children hospitalized seems to be increasing as the use of NIV. Better management of the disease from primary care and the emergency department as is the use of NIV could explain the reduction in incidence.What is Known:• Asthma is the most common chronic respiratory in childhood in high income countries.• The incidence of hospital admissions with asthma and associated factors is one of the best sources of information on morbidity trends and prognosis.What is New:• The incidence of hospital admissions for asthma in Spain decreased in children between 2011 and 2020 with a more frequent use of non-invasive mechanical ventilation and low mortality rates.• COVID-19 did not cause an increase in admissions with asthma in the year 2020.

Trends in hospital admissions and prescribing due to chronic obstructive pulmonary disease and asthma in England and Wales between 1999 and 2020: an ecological study

ObjectiveTo investigate the trends in hospital admissions and medication prescriptions related to asthma and chronic obstructive pulmonary disease (COPD) in England and Wales.MethodsAn ecological study was conducted between April 1999 and April 2020 using data extracted from the hospital episode statistics database in England and the patient episode database for Wales. The Office of National Statistics mid-year population estimates for 1999 through 2020 were collected, and medication prescription data for 2004–2020 were extracted from the prescription cost analysis database.ResultsThe total annual number of COPD and asthma hospital admissions for various causes increased by 82.2%, from 210,525 in 1999 to 383,652 in 2020, representing a 59.1% increase in hospital admission rate (from 403.77 in 1999 to 642.42 per 100,000 persons in 2020, p < 0.05). Chronic obstructive pulmonary disease with acute lower respiratory infection accounted for 38.7% of hospital admissions. Around 34.7% of all hospital admissions involved patients aged 75 and older. Around 53.8% of all COPD and asthma hospital admissions were attributable to females. The annual number of prescriptions dispensed for COPD and asthma medications increased by 42.2%.ConclusionsThroughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups. Hospitalization rates were higher for women. Further observational and epidemiological research is required to identify the factors contributing to increased hospitalization rates.