title: Trends in bronchiolitis hospitalizations in the United States, 2000-2009.
abstract: OBJECTIVE
  To examine temporal trend in the national incidence of bronchiolitis hospitalizations, use of mechanical ventilation, and hospital charges between 2000 and 2009.
  
  
  METHODS
  We performed a serial, cross-sectional analysis of a nationally representative sample of children hospitalized with bronchiolitis. The Kids Inpatient Database was used to identify children <2 years of age with bronchiolitis by International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1. Primary outcome measures were incidence of bronchiolitis hospitalizations, mechanical ventilation (noninvasive or invasive) use, and hospital charges. Temporal trends were evaluated accounting for sampling weights.
  
  
  RESULTS
  The 4 separated years (2000, 2003, 2006, and 2009) of national discharge data included 544 828 weighted discharges with bronchiolitis. Between 2000 and 2009, the incidence of bronchiolitis hospitalization decreased from 17.9 to 14.9 per 1000 person-years among all US children aged <2 years (17% decrease; P(trend) < .001). By contrast, there was an increase in children with high-risk medical conditions (5.9%-7.9%; 34% increase; P(trend) < .001) and use of mechanical ventilation (1.9%-2.3%; 21% increase; P(trend) = .008). Nationwide hospital charges increased from $1.34 billion to $1.73 billion (30% increase; P(trend) < .001); this increase was driven by a rise in the geometric mean of hospital charges per case from $6380 to $8530 (34% increase; P(trend) < .001).
  
  
  CONCLUSIONS
  Between 2000 and 2009, we found a significant decline in bronchiolitis hospitalizations among US children. By contrast, use of mechanical ventilation and hospital charges for bronchiolitis significantly increased over this same period.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA. khasegawa1@partners.org
authors.forename: Kohei
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsugawa
authors.forename: David F M
authors.initials: DF
authors.lastname: Brown
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Mansbach
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D001988:Bronchiolitis / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000639:trends; D017722:Hospital Charges / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006764:Hospitals, Community / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012121:Respiration, Artificial / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D014600:Utilization Review / Q000639:trends
keywords: bronchiolitis; hospital charge; hospitalization; incidence; mortality; trends