INCREASE IN HOSPITAL ADMISSIONS FOR CHILDHOOD ASTHMA - TRENDS IN REFERRAL, SEVERITY, AND READMISSIONS FROM 1970 TO 1985 IN A HEALTH REGION OF THE UNITED-KINGDOM
INCREASE IN HOSPITAL ADMISSIONS FOR CHILDHOOD ASTHMA - TRENDS IN REFERRAL, SEVERITY, AND READMISSIONS FROM 1970 TO 1985 IN A HEALTH REGION OF THE UNITED-KINGDOM
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DOI：
10.1136/thx.44.8.614
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发表时间：
1989-08-01
期刊：
影响因子：
10
通讯作者：
ANDERSON, HR
中科院分区：
文献类型：
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作者：
ANDERSON, HR
因儿童哮喘住院的人数继续增加，但原因不明。由于社区中急性哮喘发作的发病率大大超过入院率，这一增长可能是医疗实践的变化将护理的平衡转向医院而发病率没有任何根本变化的结果。在西南泰晤士地区（人口290万），在1978- 1985年的八年中，0-4岁和5-14岁的住院人数分别增加了186%和56%。从该地区所有医院随机抽取病例记录，检查转诊方式、入院时严重程度（发作持续时间、入院时生命体征）和再入院率变化的证据。研究结果表明，自1978年以来，入院时的严重程度没有降低，再入院率也没有增加。5-14岁年龄组的结果与同一地区早期研究（1970- 1978）的结果形成对比，在该研究中，观察到自我转诊的大量增加，再入院的增加和发作持续时间的减少;然而，入院时的脉搏和呼吸率在16年期间保持不变。总的来说，这些研究结果表明，入院人数的增加不能仅仅用医疗实践的变化来解释，可能是由于哮喘儿童严重发作的数量增加。这表明儿童哮喘的流行病学发生了变化。
Admission to hospital for childhood asthma have continued to increase, but the reasons are unknown. Because the incidence of acute asthmatic attacks in the community greatly exceeds the admission rate, this increase could be a result of changes in medical practice shifting the balance of care towards the hospital without there being any underlying change in morbidity. In the South West Thames Region (population 2.9 million) over the eight years 1978-85 the number of hospital admissions among those aged 0-4 and 5-14 rose by 186% and 56%. A random sample of case notes from all hospitals in the region was examined for evidence of changes in mode of referral, severity on admission (duration of episode, vital signs on admission), and readmission ratio. The findings indicate that there has been no reduction in severity on admission or increase in readmission rate since 1978. The findings for the 5-14 age group contrast with those from an earlier study (1970-8) in the same region, in which a substantial increase in self referral was observed together with an increase in readmissions and a reduction in the duration of the attack; pulse and respiration rates on admission have, however, remained unchanged over the 16 year period. Overall, these findings indicate that the increase in admissions cannot be satisfactorily explained by changes in medical practice alone and may be due to an increase in the number of asthmatic children experiencing severe attacks. This points to a change in the epidemiology of childhood asthma.