A COHORT STUDY ON CHILDHOOD ASTHMA ADMISSIONS AND READMISSIONS

Background. Admissions to hospitals for childhood asthma seem to be in creasing, even though admissions for other childhood conditions are de creasing. We studied admissions and readmissions for childhood asthma in Ontario in an attempt to uncover factors relating to the admission patterns. Methods. Using the hospital discharge data from the Canadian Institute for Health Information, 28 646 children with diagnoses of a sthma were identified from April 1, 1989, to March 31, 1992. Results. The admission rates for asthma among children in Ontario showed a 14.8 % decrease from 1987 to 1992. This decline was observed primarily in 5 - to 17-year-olds. Younger children had a fourfold risk of hospital ad mission for asthma. In the 4 years studied, 10 427 children (36.4%) we re readmitted at least once, representing 22 114 readmissions, 16 196 (73.2%) of which were for asthma. The 6-month probabilities of readmis sion for asthma were 20.0% (0- to 4-year-olds) and 11.7% (5- to 17-yea r-olds). The estimated relative risks (RRs) indicated that younger chi ldren had a significantly higher risk of readmission for asthma (RR, 1 .38; 95% confidence interval, 1.30 to 1.46) or asthma-related causes ( RR, 5.02; 95% confidence interval, 4.16 to 6.05). Conclusions. The obs erved increasing trend in admissions for asthma among children in the 1970s and 1980s leveled off in the early 1990s. The declining admissio n rates were largely caused by the lower admission rates among school- aged children from 5 to 17 years. The relatively high admission and re admission rates of preschool children are still a concern. Further res earch is necessary to examine factors that influence admissions for as thma among young children.