title: Twenty year trends in hospital discharges for asthma among members of a health maintenance organization.
abstract: We examined trends in hospitalizations for asthma from 1967 to 1987 among members of a large health maintenance organization. During this time asthma discharges increased significantly among children, and especially among boys under the age of 5 years. Ninety-five percent of the increase in discharges among boys was explained by a corresponding increase in the number of boys who were hospitalized. Increased readmissions did not account for the rise. Changes in the International Classification of Diseases coding of asthma and diagnostic shift by physicians accounted for only part of the increase. A decline in hospitalizations since 1984 may reflect changes in the management of asthma in the emergency room and not a decline in severe asthma episodes.
authors.affiliation: Kaiser Permanente Center for Health Research, Portland, OR 97227.
authors.forename: W M
authors.initials: WM
authors.lastname: Vollmer
authors.forename: A S
authors.initials: AS
authors.lastname: Buist
authors.forename: M L
authors.initials: ML
authors.lastname: Osborne
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001991:Bronchitis / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends*; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends; D016012:Poisson Distribution; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000453:epidemiology; D012737:Sex Factors