Hospitalization Rates In Children Research Articles

Burn prevention programs for children: do they reduce burn-related hospitalizations?

Background: Severe burns in children can result in prolonged suffering, disability, disfigurement, and in impaired physical and mental development. Hospitalization rates of children with burns are much higher than for children with other trauma. Therefore, various child burn prevention programs have been implemented, but their efficacy has been evaluated only by assessment of knowledge or satisfaction rather than evaluating actual changes in burn-related hospitalizations. Our objective was to map Israeli child burn prevention programs and to measure their success from the rate of burn-related hospitalizations. Methods: A questionnaire-based survey was conducted of organizations participating in injury prevention programs. Official data was obtained on burn-related hospitalizations of children aged 0–4 and 5–14 for 1998 and 2000, and was correlated with the existence or absence of injury prevention programs, and with the population's socio-economic status (SES). Results: In localities with burn prevention programs, there was a reduction in the rate of burn-related hospitalizations of infants, from 1.39 to 1.05 per 1000 infants ( p < 0.05), in contrast to localities where programs did not exist. The greatest change was in middle and high socio-economic communities. The prevention programs had no similar effects on school-aged children. Conclusion: Injury prevention programs are effective in reducing burn-related hospitalizations among infants and toddlers, especially from more affluent communities, but not among school-aged children.

Full and Incomplete Fetal Alcohol Syndrome

The clinical features and hospitalization rates of children with full or incomplete fetal alcohol syndrome (FAS) were compared in retrospective case-controlled studies of affected Northern Plains American Indian children attending Aberdeen Area Indian Health Service hospitals, South Dakota.

Characteristics of fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is the most common preventable cause of mental retardation in the US. Kvigne et al have worked with four Northern Plains tribes attending Aberdeen Area Indian Health Service hospitals and clinics to characterize the clinical features and hospitalization rates in children with full or incomplete FAS. They report their findings in this issue of The Journal. The study reports a high frequency of facial dysmorphology, growth deficiency, CNS dysfunction, and muscular problems, together with high hospital admission rates for otitis media, pneumonia, dehydration and anemia. There was also a very high rate of being removed from the home through a social service intervention among the cases identified. The authors conclude that this population of children has many medical, educational, and social needs and that they benefit from careful evaluation by health-care providers and expanded community programs. Characteristics of children who have full or incomplete fetal alcohol syndromeThe Journal of PediatricsVol. 145Issue 5PreviewTo describe the clinical features and hospitalization rates of American Indian children with full or incomplete fetal alcohol syndrome (FAS). Full-Text PDF

Inhaled corticosteroids in childhood asthma: Income differences in use.

Asthma hospitalization rates in children increase with decreasing level of household income. This research was undertaken to determine whether use of inhaled corticosteroid drugs, which can prevent asthma hospitalizations, followed a similar socioeconomic gradient in children with asthma. We performed a cross-sectional study of association, using population-based prescription and healthcare data sources. Our subjects were 16,862 Manitoba children, aged 5-15 years, with prescriptions for asthma drugs during January 1995-March 1996. Our measures were adjusted for asthma severity, physician specialty, and proportion of children with an inhaled corticosteroid prescription by neighborhood income. Forty-five percent of children treated for asthma had at least one inhaled corticosteroid prescription during January 1995-March 1996. The proportion of children with inhaled corticosteroid prescriptions decreased with successive decreases in neighborhood income. The socioeconomic gradient in the likelihood of an inhaled corticosteroid prescription was most evident among children with mild-moderate asthma who were not in the care of an asthma specialist. In conclusion, a socioeconomic gradient in the use of inhaled corticosteroids prescriptions can be found among children with universal access to healthcare and drug insurance.

Health Service Utilization by Manitoba Children

To compare physician and hospital utilization rates by children across subregions of Manitoba. 1998/99 data for physician visits and hospitalizations for children aged 0 to 19 were extracted from the Population Health Research Data Repository. Rates of utilization were compared across 12 regions (RHAs) within Manitoba, and 12 community areas within Winnipeg. Rates were also compared across premature mortality rates (PMR) and area income levels. Substantial regional variation was found for utilization rates. The hospitalization rate for children from the three northern RHAs (highest PMRs) (114/1000) was almost four times the Winnipeg rate (30/1000) and almost double the rate for the rural south RHAs (lowest PMRs) (59/1000). The variation among regions in physician visits ranged from under 2 visits in 2 of the northern RHAs to almost 4 visits in urban areas. However, the low visit rates in rural RHAs are offset somewhat by greater use of nurses. Hospitalizations and physician visits were also related to area income level. Findings are discussed in terms of health care need.

Searching for glycemic control in pediatric type 1 diabetes: A long way to go

Searching for glycemic control in pediatric type 1 diabetes: A long way to go

The incidence of Kawasaki syndrome in West Coast health maintenance organizations.

Kawasaki syndrome (KS) causes an acute vasculitis of unknown etiology. It is a leading cause of acquired heart disease of children in Japan and the United States. We examined the incidence of KS in a well-defined population group of children < or =6 years of age, using data collected through the Vaccine Safety Datalink (VSD) project. The VSD database contains information on >1 million children enrolled in four West Coast health maintenance organizations (HMOs). During 1993 through 1996 a total of 234 physician-diagnosed KS patients were reported in the 4 HMOs; 152 (65.0%) were boys and 195 (83.3%) were <5 years of age. The incidence of KS among children <5 years of age in the HMOs ranged from 9.0 to 19.1 per 100,000 person years. KS incidence was higher among boys in 3 of the sites. In the 2 sites with the highest number of KS patients, a seasonal occurrence of KS in winter and early spring was observed. Overall 226 (96.6%) of the KS patients were reported to have been hospitalized; hospitalization rates for children <5 years of age ranged from 9.0 to 16.8 per 100,000 person years. The incidence of KS in the HMOs was similar to that reported in other population-based studies in the United States and higher than estimates for Australia and several European countries.

Review: Ipratropium bromide with β-agonists improves pulmonary function and reduces hospitalizations in acute asthma

TherapeuticsJuly 1, 2000Review: Ipratropium bromide with β-agonists improves pulmonary function and reduces hospitalizations in acute asthmaJay Peters, MDJay Peters, MDUniversity of Texas Health Science Center at San Antonio, San Antonio, Texas, USA (J.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2000-133-1-001 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail Source CitationRodrigo G, Rodrigo C, Burschtin O. A meta-analysis of the effects of ipratropium bromide in adults with acute asthma. Am J Med. 1999 Oct;107:363-70. https://pubmed.ncbi.nlm.nih.gov/10527039References1 National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma: expert panel report 2. Bethesda, MD: U.S. Department of Health and Human Services, 1997; NIH publication no. 97-4051. Google Scholar2 British Guidelines Coordinating Committee. British guidelines on asthma management: 1995. Review and position statement. Thorax. 1997;52:S1-30. Google Scholar3 Qureshi F, Pestian J, Davis P, Zaritsky A. Effect of nebulized ipratropium on the hospitalization rates of children with asthma. N Engl J Med. 1998;339:1030-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA (J.P.) Nextarticle Advertisement FiguresReferencesRelatedDetails July 1, 2000Volume 133, Issue 1Page: 1KeywordsAsthmaChildrenHospitalizationsInformation storage and retrievalLungsPulmonary functionStatistical data ePublished: 9 March 2020 Issue Published: July 1, 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Effect of Nebulized Ipratropium on the Hospitalization Rates ofChildren With Asthma

1. Qureshi F, 2. Pestian J, 3. Davis P, 4. et al. (1998) N Engl J Med. 339:1030–1035. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] #### Purpose β-agonists have been identified as primary therapy for acute asthma and adjunctive therapy with anticholinergic agents has yielded variable results. This study evaluates the addition of ipratropium to β-agonist in the treatment of acute asthma. ##### Study Population A double-blind study of 434 children (2–18 years) … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DQureshi%26rft.auinit1%253DF.%26rft.volume%253D339%26rft.issue%253D15%26rft.spage%253D1030%26rft.epage%253D1035%26rft.atitle%253DEffect%2Bof%2BNebulized%2BIpratropium%2Bon%2Bthe%2BHospitalization%2BRates%2Bof%2BChildren%2Bwith%2BAsthma%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJM199810083391503%26rft_id%253Dinfo%253Apmid%252F9761804%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJM199810083391503&link_type=DOI [3]: /lookup/external-ref?access_num=9761804&link_type=MED&atom=%2Fpediatrics%2F104%2FSupplement_2%2F394.2.atom [4]: /lookup/external-ref?access_num=000076294800003&link_type=ISI

Effect of Nebulized Ipratropium on the Hospitalization Rates ofChildren With Asthma

Qureshi F, Pestian J, Davis P, et alN Engl J Med.339199810301035β-agonists have been identified as primary therapy for acute asthma and adjunctive therapy with anticholinergic agents has yielded variable results. This study evaluates the addition of ipratropium to β-agonist in the treatment of acute asthma.A double-blind study of 434 children (2–18 years) with acute asthma.All patients received a weight appropriate dose of inhaled albuterol (2.5 to 5.0 mg) every 20 minutes. At the second dose 2 mg/kg of prednisolone was administered. The treatment group was administered 500 μg ipratropium bromide with doses number 2 and 3 and the control group was given placebo.Overall, the hospitalization rate was lower in the group given ipratropium. This was particularly evident in the patients where the initial PEFR was <50% and the asthma symptom score was elevated. The addition of ipratropium resulted in a hospitalization rate that decreased from 52% to 38% in the most severely affected patients.In a study published in the Journal of Pediatrics in the same month, no effect was discerned with the addition of ipratropium 250 μg to two dosing ranges of albuterol. There appears to be an inconsistent additive effect when ipratropium is added to albuterol. Patients who have more severe airway obstruction and who do not respond to initial β-agonist therapy are more likely to respond to combined therapy.

An association between fine particles and asthma emergency department visits for children in Seattle.

Asthma is the most common chronic illness of childhood and its prevalence is increasing, causing much concern for identification of risk factors such as air pollution. We previously conducted a study showing a relationship between asthma visits in all persons < 65 years of age to emergency departments (EDs) and air pollution in Seattle, Washington. In that study the most frequent zip codes of the visits were in the inner city. The Seattle-King County Department of Public Health (Seattle, WA) subsequently published a report which showed that the hospitalization rate for children in the inner city was over 600/100,000, whereas it was < 100/100,000 for children living in the suburbs. Therefore, we conducted the present study to evaluate whether asthma visits to hospital emergency departments in the inner city of Seattle were associated with outdoor air pollution levels. ED visits to six hospitals for asthma and daily air pollution data were obtained for 15 months during 1995 and 1996. The association between air pollution and childhood ED visits for asthma from the inner city area with high asthma hospitalization rates were compared with those from lower hospital utilization areas. Daily ED counts were regressed against fine particulate matter (PM), carbon monoxide (CO), sulfur dioxide, and nitrogen dioxide using a semiparametric Poisson regression model. Significant associations were found between ED visits for asthma in children and fine PM and CO. A change of 11 microg/m3 in fine PM was associated with a relative rate of 1.15 [95% confidence interval (CI), 1.08-1.23]. There was no stronger association between ED visits for asthma and air pollution in the higher hospital utilization area than in the lower utilization area. These findings were seen when estimated PM2.5 concentrations were below the newly adopted annual National Ambient Air Quality Standard of 15 microg/m3.

Effect of Nebulized Ipratropium on the Hospitalization Rates of Children with Asthma

Background Anticholinergic medications such as ipratropium improve the pulmonary function of patients with acute exacerbations of asthma, but their effect on hospitalization rates is uncertain. Methods We conducted a randomized, double-blind, placebo-controlled study of 434 children (2 to 18 years old) who had acute exacerbations of moderate or severe asthma treated in the emergency department. All the children received a nebulized solution of albuterol (2.5 or 5 mg per dose, depending on body weight) every 20 minutes for three doses and then as needed. A corticosteroid (2 mg of prednisone or prednisolone per kilogram of body weight) was given orally with the second dose of albuterol. Children in the treatment group received 500 μg (2.5 ml) of ipratropium bromide with the second and third doses of albuterol; children in the control group received 2.5 ml of normal saline at these times. Results Overall, the rate of hospitalization was lower in the ipratropium group (59 of 215 children [27.4 percent]) than ...

Effect of Nebulized Ipratropium on the Hospitalization Rates of Children with Asthma

Effect of Nebulized Ipratropium on the Hospitalization Rates of Children with Asthma

An Association between Fine Particles and Asthma Emergency Department Visits for Children in Seattle

Asthma is the most common chronic illness of childhood and its prevalence is increasing, causing much concern for identification of risk factors such as air pollution. We previously conducted a study showing a relationship between asthma visits in all persons &lt; 65 years of age to emergency departments (EDs) and air pollution in Seattle, Washington. In that study the most frequent zip codes of the visits were in the inner city. The Seattle-King County Department of Public Health (Seattle, WA) subsequently published a report which showed that the hospitalization rate for children in the inner city was over 600/100,000, whereas it was &lt; 100/100,000 for children living in the suburbs. Therefore, we conducted the present study to evaluate whether asthma visits to hospital emergency departments in the inner city of Seattle were associated with outdoor air pollution levels. ED visits to six hospitals for asthma and daily air pollution data were obtained for 15 months during 1995 and 1996. The association between air pollution and childhood ED visits for asthma from the inner city area with high asthma hospitalization rates were compared with those from lower hospital utilization areas. Daily ED counts were regressed against fine particulate matter (PM), carbon monoxide (CO), sulfur dioxide, and nitrogen dioxide using a semiparametric Poisson regression model. Significant associations were found between ED visits for asthma in children and fine PM and CO. A change of 11 microg/m3 in fine PM was associated with a relative rate of 1.15 [95% confidence interval (CI), 1.08-1.23]. There was no stronger association between ED visits for asthma and air pollution in the higher hospital utilization area than in the lower utilization area. These findings were seen when estimated PM2.5 concentrations were below the newly adopted annual National Ambient Air Quality Standard of 15 microg/m3.

Hospital Utilization of Saskatchewan People with Fetal Alcohol Syndrome

We describe the hospital utilization of 194 Saskatchewan persons with Fetal Alcohol Syndrome (88% Aboriginal), born between 1973-92. Complete provincial hospitalization data were obtained for 128 patients; partial data for 29 patients. Proportionately more persons missing data were adopted, not living with biological family members or were deceased. The hospital separation rates for the children with FAS, pooled from 1987-91, compared to the 1989-90 Saskatchewan rates were significantly higher (95% level of confidence) for males and females < 1 year, 1-4 years and 5-14 years of age. Relative to Saskatchewan Registered Indians, significantly higher hospitalization rate ratios were observed for males with FAS in all age groups and for females only age 5-14 years. Rate ratios for younger females may not have achieved significance because of missing data. Higher hospitalization rates in children with FAS may not be explained solely by factors associated with ethnicity.

Hospital utilization of Saskatchewan people with fetal alcohol syndrome.

We describe the hospital utilization of 194 Saskatchewan persons with Fetal Alcohol Syndrome (88% Aboriginal), born between 1973-92. Complete provincial hospitalization data were obtained for 128 patients; partial data for 29 patients. Proportionately more persons missing data were adopted, not living with biological family members or were deceased. The hospital separation rates for the children with FAS, pooled from 1987-91, compared to the 1989-90 Saskatchewan rates were significantly higher (95% level of confidence) for males and females < 1 year, 1-4 years and 5-14 years of age. Relative to Saskatchewan Registered Indians, significantly higher hospitalization rate ratios were observed for males with FAS in all age groups and for females only age 5-14 years. Rate ratios for younger females may not have achieved significance because of missing data. Higher hospitalization rates in children with FAS may not be explained solely by factors associated with ethnicity.

Effect of a Pediatric Observation Unit on the Rate of Hospitalization for Asthma

Study objective: To determine the asthma admission rate and the rate of repeat visits to the emergency department for asthma within 72 hours before and after the introduction of an observation unit (OU). When necessary, admission to the ward from the OU is usually made within 12 hours. Methods: We conducted a before-and-after study with retrospective data collection in an urban tertiary care pediatric ED. Our subjects were patients aged 1 to 18 years who presented to the ED with asthma. The pre-OU group comprised patients seen between July 1, 1991, and June 30, 1992, before the opening of the OU. The post-OU group consisted of children seen between July 1, 1993, and June 30, 1994, after the opening of the OU. Results: The pre- and post-OU groups had 1,979 and 2,248 asthma visits, respectively. The admission rate decreased from 31% in the pre-OU group to 24% in the post-OU group ( P<.01). The frequency of inpatient admissions of less than 24 hours decreased from 17% in the pre-OU group to 10% in the post-OU group ( P≤.01). The rate of repeat ED visits within 72 hours was 3% in the pre-OU group and 5% in the post-OU group ( P=.01). Conclusion: The use of an OU in the ED was associated with a reduction in the hospitalization rate for children with acute asthma exacerbation. However, we also noted an increased rate of repeat visits to the ED after the introduction of the OU. [Gouin S, Macarthur C, Parkin PC, Schuh S: Effect of a pediatric observation unit on the rate of hospitalization for asthma. Ann Emerg Med February 1997;29:218-222.]

Hospitalization rates of children with croup in Ontario

Hospitalization rates of children with croup in Ontario

Time spent in hospital by children as a health care indicator: inter-district comparisons

It has been widely recommended that children should be admitted to hospital only if treatment cannot be provided at home, and that durations of hospital stay should be minimized. We have used record linkage to calculate a statistic which is not yet commonly available, the total time spent in hospital by children per year, and have compared this between six districts in the Oxford Region. Hospitalization rates for children who stayed a total of two days or less per year in hospital increased over time; rates for children who stayed more than two days declined. Mean and median total days spent in hospital varied between districts but, in absolute terms, the differences were small at less than one day's difference between districts per year per child admitted. Inter-district variation decreased over time, although the variation in use of day case care which remained suggests that some districts could still do more work in this fashion.

Trends in the hospitalization for acute childhood asthma, 1970-84.

Data from the 1970 through 1984 National Hospital Discharge Surveys indicate that the rate of hospitalization for children under 15 years old with asthma has increased at least 145 per cent while the average length of stay for children with asthma decreased by 26 per cent from 5 days in 1970 to 3.6 days in 1984. Over an analogous period (1970 to 1980), data from the National Health Interview Survey indicate that the prevalence of childhood asthma has increased by approximately 28 per cent for children 6 to 16 years of age. Several potential explanations for the hospital trend are discussed, including changes in the disease classification and information system, criteria for admission, organizational factors, changes in therapy, and changes in morbidity.