title: Extended-stay hospitalization for childhood asthma in Japan.
abstract: BACKGROUND
  While recent advances in asthma management have enabled adequate control to be frequently achieved in outpatient settings, children whose asthma remains poorly controlled despite outpatient treatment are often referred to extended-stay hospitals. The aim of the present study was to examine trends concerning extended-stay hospitalization and to evaluate the present status of this approach.
  
  
  METHODS
  A retrospective study was conducted to assess changes in the number of admissions among 408 children with extended stays at Kamiamakusa General Hospital between 1989 and 2005. Medical and laboratory data of 236 patients admitted since 1994 were obtained from clinical records.
  
  
  RESULTS
  The number of children with extended-stay hospitalizations since 2000 declined dramatically compared with the early 1990s, while the percentage of patients with complications of childhood asthma, such as severe atopic dermatitis, school absenteeism, and obesity, have increased significantly in the recent past. Practical benefits of extended-stay hospitalization were demonstrated by significant improvement of exercise performance and measurement of pulmonary function parameters and serum IgE concentrations by time of discharge. In addition to improvement in asthmatic symptoms, maintenance drug requirements and frequency of school absenteeism were reduced.
  
  
  CONCLUSIONS
  The medical mission of extended-stay hospitalizations is currently limited due to the availability of improved pharmacotherapy. Some patients, however, with exceptionally severe asthma or psychological problems that interact with their medical condition still fare poorly under outpatient care and could benefit from group care. Further study is needed to identify the components of long-term programs essential to produce change.
authors.affiliation: Department of Pediatrics, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tani
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsuda
authors.forename: Takao
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Ikue
authors.initials: I
authors.lastname: Hiramoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Okamatsu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takehiro
authors.forename: Kouichi
authors.initials: K
authors.lastname: Kimura
authors.forename: Sadanobu
authors.initials: S
authors.lastname: Higuchi
authors.forename: Reiji
authors.initials: R
authors.lastname: Okazaki
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matsuishi
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007073:Immunoglobulin E