RATES OF ADMISSION TO HOSPITAL FOR ASTHMA

Objective-To describe trends in hospital admission rates for asthma in England and Wales (1976-85), the East Anglian region (from 1976 to 19 91-2), and Wales (1980-90). Design-Descriptive study. Setting-Hospital s in England and Wales; hospitals in the East Anglian Regional Health Authority; hospitals in Wales. Main outcome measures-Hospital admissio ns for asthma as principal diagnosis in England and Wales (Hospital In -patient Enquiry, 1976-85), for the East Anglian region (Hospital In-p atient Enquiry, 1976-7; Hospital Activity Analysis, 1978-86; Regional Information System, 1987-8 to 1991-2), and for Wales (Hospital Activit y Analysis, l980-90). Results-Rates for England and Wales as a whole s howed a steady upward trend throughout the period examined. Rates in E ast Anglia, though they were similar to the national trends in the ear ly years, showed a peak in 1985 (for males and females) with some indi cation of a decline in rates thereafter. Rates for Wales showed an upw ard trend until 1988 (for both males and females) after which they sho wed a decline. Conclusions-Interpretation of the East Anglian trends i s made more difficult by the change in England in 1987 of the system f or the collection of hospital admission data. The fact that the rates for the East Anglian region seem to decline before this change and oth er considerations suggest that the observed trends, although partly re flecting the disruption of the coding during the changeover in systems , may not be entirely artefactual. The possible roles of diagnostic tr ansfer and changes in the delivery of care, asthma treatment, admissio n and readmission policies, and the severity and prevalence of asthma in changing admission rates are considered. The changing bends in admi ssion rates for East Anglia and Wales reflect recently published trend s for mortality from asthma in England.