Hospital admission trends for pediatric asthma: results of a 10 year survey in Israel.
BACKGROUND
In the last decade there has been an increase in asthma morbidity. Hospital admission rates for childhood asthma are influenced by the prevalence of asthma and the quality of asthma care.


OBJECTIVE
To assess trends in hospital admission and readmission rates for childhood asthma in the Jezreel Valley in Israel in the last decade, and to evaluate the possible effect of changes in asthma treatment on hospitalization for acute asthma during this period.


METHODS
All records of pediatric patients from the central hospital in the Jezreel Valley in northeastern Israel over a 10 year period from 1990 through 1999 who were diagnosed as having asthma were thoroughly reviewed and analyzed for admissions, re-admissions, and treatment before and during admissions


RESULTS
There were 1584 admissions, 1208 were first-time admissions and 376 were re-admissions. The number of first-time admissions increased significantly over time (P < 0.0001), with a significant decrease in re-admissions (P < 0.005); this finding was more significant in children under the age of 8 years (P < 0.005). The length of hospital stay decreased significantly from 3.3 days to 2.7 days (P < 0.002). Significant changes in the use of medications included an increase in inhalant glucocorticoids and a decrease in the use of sodium cromoglycate and theophylline. Controller medication use was concomitant with a significant decrease in the re-admission rates.


CONCLUSIONS
The increase in the admission rate and the decrease in the rate of re-admissions and the length of hospital stay probably reflect the increase in the prevalence of asthma and changes in its treatment, respectively. It is essential that asthma be recognized as a significant cause of morbidity and that controller medications be administered to decrease its severity, morbidity, and resultant hospital admissions.
Rottem
Menachem
M
Division of Allergy Asthma and Immunology, HaEmek Medical Center, Afula, Israel. menachem@rottem.net
Zitansky
Ana
A
Horovitz
Yoseph
Y
D000293:Adolescent; D017677:Age Distribution; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data