Trends in childhood asthma: Prevalence, health care utilization, and mortality
Trends in childhood asthma: Prevalence, health care utilization, and mortality
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DOI：
10.1542/peds.110.2.315
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发表时间：
2002-08-01
期刊：
影响因子：
8
通讯作者：
Schoendorf, KC
中科院分区：
文献类型：
--
作者：
Akinbami, LJ;Schoendorf, KC
目标。我们的目标是利用国家数据对儿童哮喘患病率、医疗保健利用和死亡率的趋势进行全面描述，以评估美国儿童疾病负担的变化。来自国家卫生统计中心的五个数据来源被用来描述从1980年到可获得数据的最近一年0至17岁儿童哮喘的趋势。这些调查包括全国健康访谈调查(NHIS)、全国非卧床医疗护理调查、国家医院非卧床医疗护理调查、国家医院出院调查以及国家生命统计系统中的死亡部分。从1980年到1996年，哮喘患病率平均每年增长4.3%，从3.6%上升到6.2%。患病率最高的是1995年的7.5%。1997年，哮喘发作患病率为5.4%，但1997年NHIS设计的变化排除了与先前估计的比较。从1997年到2000年，哮喘发作患病率一直保持在较高水平。在1980至1989年间有所下降后，1989至1999年间哮喘办公室就诊率平均每年增加3.8%。1980~1999年哮喘住院率年均增长1.4%。虽然儿童哮喘死亡很少见，但从1980年到1998年，哮喘死亡率每年增加3.4%。0至4岁的儿童患病率增加最多，使用医疗保健的人数最多，但青少年的死亡率最高。在这段时间里，黑人儿童承担了不成比例的哮喘负担。在哮喘住院和死亡率方面，种族差异最大：与白人儿童相比，19971998-1999年，黑人儿童住院的可能性是白人儿童的3倍，死于哮喘的可能性是白人儿童的4倍。最近的数据表明，儿童哮喘的负担在经历了几年的增加后，最近可能已经趋于平稳，尽管有必要额外收集几年的数据来确认趋势的变化。在哮喘、保健利用和死亡率方面，种族和族裔差异仍然很大。
Objectives. Our objective was to use national data to produce a comprehensive description of trends in childhood asthma prevalence, health care utilization, and mortality to assess changes in the disease burden among US children.Methods. Five data sources from the National Center for Health Statistics were used to describe trends in asthma for children aged 0 to 17 years from 1980 to the most recent year for which data were available. These included the National Health Interview Survey (NHIS), the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, the National Hospital Discharge Survey, and the Mortality Component of the National Vital Statistics System.Results. Asthma prevalence increased by an average of 4.3% per year from 1980 to 1996, from 3.6% to 6.2%. The peak prevalence was 7.5% in 1995. In 1997, asthma attack prevalence was 5.4%, but changes in the NHIS design in 1997 preclude comparison to previous estimates. Asthma attack prevalence remained level from 1997 to 2000. After a decrease between 1980 and 1989, the asthma office visit rate increased by an average of 3.8% per year from 1989 to 1999. The asthma hospitalization rate grew by 1.4% per year from 1980 to 1999. Although childhood asthma deaths are rare, the asthma death rate increased by 3.4% per year from 1980 to 1998. Children aged 0 to 4 years had the largest increase in prevalence and had greater health care use, but adolescents had the highest mortality. The asthma burden was borne disproportionately by black children throughout the period. Racial disparities were largest for asthma hospitalizations and mortality: compared with white children, in 1998-1999, black children were >3 times as likely to be hospitalized and in 19971998 >4 times as likely to die from asthma.Conclusions. Recent data suggest that the burden from childhood asthma may have recently plateaued after several years of increasing, although additional years of data collection are necessary to confirm a change in trend. Racial and ethnic disparities remain large for asthma health care utilization and mortality.