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Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma
BackgroundAdmission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistic...
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| Published in: | Archives of disease in childhood 2016-02, Vol.101 (2), p.140-146 |
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| container_title | Archives of disease in childhood |
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| creator | Green, Christopher A Yeates, David Goldacre, Allie Sande, Charles Parslow, Roger C McShane, Philip Pollard, Andrew J Goldacre, Michael J |
| description | BackgroundAdmission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistics (HES, 1989–2011), Oxford Record Linkage Study (ORLS, 1963–2011) and Paediatric Intensive Care Audit Network (PICANet, 2003–2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.ResultsAll-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged |
| doi_str_mv | 10.1136/archdischild-2015-308723 |
| format | article |
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We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistics (HES, 1989–2011), Oxford Record Linkage Study (ORLS, 1963–2011) and Paediatric Intensive Care Audit Network (PICANet, 2003–2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.ResultsAll-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged <1 year between 1979 and 2011. In 2011 the estimated annual hospital admission rate was 46.1 (95% CI 45.6 to 46.6) per 1000 infants aged <1 year. Between 2004 and 2011 the rates rose by an average of 1.8% per year in the all-England HES data, whereas admission rates to paediatric intensive care changed little (1.3 to 1.6 per 1000 infants aged <1 year). A fivefold geographical variation in hospital admission rates was observed. Young maternal age, low social class, low birth weight and maternal smoking were among factors associated with an increased risk of hospital admission with bronchiolitis.ConclusionsHospital admissions for infants with bronchiolitis have increased substantially in recent years. However, cases requiring intensive care have changed little since 2004.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2015-308723</identifier><identifier>PMID: 26342094</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Admission and discharge ; Adolescent ; Adult ; Analysis ; Asthma ; Asthma - epidemiology ; Asthma - etiology ; Asthma in children ; Attrition (Research Studies) ; Birth Weight ; Bronchiolitis ; Bronchiolitis - complications ; Bronchiolitis - epidemiology ; Bronchiolitis - therapy ; Bronchitis ; Cerebral Palsy ; Child, Preschool ; Childhood asthma ; Company business management ; Down Syndrome ; England - epidemiology ; Hospital admission and discharge ; Hospitalization - statistics & numerical data ; Hospitalization - trends ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infants ; Infections ; Intensive care ; Intensive Care Units, Pediatric - statistics & numerical data ; Intensive Care Units, Pediatric - trends ; Linked Data ; Local government ; Management ; Maternal Age ; Medical Record Linkage ; Methods ; Mortality ; Original ; Patient Admission - statistics & numerical data ; Patient Admission - trends ; Patient admissions ; Pediatric intensive care units ; Physicians ; Place of Residence ; Population ; Respiratory syncytial virus ; Risk Factors ; Smoking - adverse effects ; Smoking - epidemiology ; Social Class ; Trend Analysis ; Trends ; Ventilation ; Young Adult ; Young Children</subject><ispartof>Archives of disease in childhood, 2016-02, Vol.101 (2), p.140-146</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b600t-90ca35727ae55fa4bd1c58a28414900f1ceefe64a24f51a63b6bce67e23b81093</citedby><cites>FETCH-LOGICAL-b600t-90ca35727ae55fa4bd1c58a28414900f1ceefe64a24f51a63b6bce67e23b81093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1828878988/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1828878988?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,776,780,881,21357,21373,27901,27902,33588,33589,33854,33855,43709,43856,73964,74140</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26342094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Green, Christopher A</creatorcontrib><creatorcontrib>Yeates, David</creatorcontrib><creatorcontrib>Goldacre, Allie</creatorcontrib><creatorcontrib>Sande, Charles</creatorcontrib><creatorcontrib>Parslow, Roger C</creatorcontrib><creatorcontrib>McShane, Philip</creatorcontrib><creatorcontrib>Pollard, Andrew J</creatorcontrib><creatorcontrib>Goldacre, Michael J</creatorcontrib><title>Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>BackgroundAdmission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistics (HES, 1989–2011), Oxford Record Linkage Study (ORLS, 1963–2011) and Paediatric Intensive Care Audit Network (PICANet, 2003–2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.ResultsAll-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged <1 year between 1979 and 2011. In 2011 the estimated annual hospital admission rate was 46.1 (95% CI 45.6 to 46.6) per 1000 infants aged <1 year. Between 2004 and 2011 the rates rose by an average of 1.8% per year in the all-England HES data, whereas admission rates to paediatric intensive care changed little (1.3 to 1.6 per 1000 infants aged <1 year). A fivefold geographical variation in hospital admission rates was observed. Young maternal age, low social class, low birth weight and maternal smoking were among factors associated with an increased risk of hospital admission with bronchiolitis.ConclusionsHospital admissions for infants with bronchiolitis have increased substantially in recent years. However, cases requiring intensive care have changed little since 2004.</description><subject>Admission and discharge</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis</subject><subject>Asthma</subject><subject>Asthma - epidemiology</subject><subject>Asthma - etiology</subject><subject>Asthma in children</subject><subject>Attrition (Research Studies)</subject><subject>Birth Weight</subject><subject>Bronchiolitis</subject><subject>Bronchiolitis - complications</subject><subject>Bronchiolitis - epidemiology</subject><subject>Bronchiolitis - therapy</subject><subject>Bronchitis</subject><subject>Cerebral Palsy</subject><subject>Child, Preschool</subject><subject>Childhood asthma</subject><subject>Company business management</subject><subject>Down Syndrome</subject><subject>England - epidemiology</subject><subject>Hospital admission and discharge</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitalization - trends</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Intensive Care Units, Pediatric - statistics & numerical data</subject><subject>Intensive Care Units, Pediatric - trends</subject><subject>Linked Data</subject><subject>Local government</subject><subject>Management</subject><subject>Maternal Age</subject><subject>Medical Record Linkage</subject><subject>Methods</subject><subject>Mortality</subject><subject>Original</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patient Admission - trends</subject><subject>Patient admissions</subject><subject>Pediatric intensive care units</subject><subject>Physicians</subject><subject>Place of Residence</subject><subject>Population</subject><subject>Respiratory syncytial virus</subject><subject>Risk Factors</subject><subject>Smoking - adverse effects</subject><subject>Smoking - epidemiology</subject><subject>Social Class</subject><subject>Trend Analysis</subject><subject>Trends</subject><subject>Ventilation</subject><subject>Young Adult</subject><subject>Young Children</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ALSLI</sourceid><sourceid>CJNVE</sourceid><sourceid>M0P</sourceid><recordid>eNqNksGO0zAQhiMEYrsLr4AsceFAwI4dx-GAVFW7gLTSXuBsTZxJ4iq1i-0WeCTeEpeU1cKJkzX2N__MeP6iIIy-YYzLtxDM1NtoJjv3ZUVZXXKqmoo_KlZMSJWvhHhcrCilvGyVUhfFZYxbSlmlFH9aXFSSi4q2YlX8XPc7G6P1jiRPJh_3NsFMBh9IF7zLFfxsk43EOnLtxhlc_46kgK6PxB8xkMEekfRooMf4mozoxwD7yZoscoRgIZ2kcxaBGL05x99smsgeg3VwqmYmCGBSjmOyJv7G46GL-PWALuXMNO3gWfFkgDni8_N5VXy5uf68-Vje3n34tFnflp2kNJUtNcDrpmoA63oA0fXM1AoqJZhoKR2YQRxQCqjEUDOQvJOdQdlgxTvFaMuviveL7v7Q7bA3uYMAs94Hu4PwQ3uw-u8XZyc9-qMWTV1JobLAq7NA8HmAmHT-YYNz_jv0h6hZI2mbt9g0GX35D7r1h-DyeJqpvKtG5e1lqlyoEWbU1hnvEn5Pxs8zjqjz9Js7vRZCSUl5U2deLbwJPsaAw33zjOqTf_RD_-iTf_Tin5z64uHw94l_DJMBvgDdbvv_sr8AOXbakw</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Green, Christopher A</creator><creator>Yeates, David</creator><creator>Goldacre, Allie</creator><creator>Sande, Charles</creator><creator>Parslow, Roger C</creator><creator>McShane, Philip</creator><creator>Pollard, Andrew J</creator><creator>Goldacre, Michael J</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160201</creationdate><title>Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma</title><author>Green, Christopher A ; Yeates, David ; Goldacre, Allie ; Sande, Charles ; Parslow, Roger C ; McShane, Philip ; Pollard, Andrew J ; Goldacre, Michael J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b600t-90ca35727ae55fa4bd1c58a28414900f1ceefe64a24f51a63b6bce67e23b81093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Admission and discharge</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis</topic><topic>Asthma</topic><topic>Asthma - epidemiology</topic><topic>Asthma - etiology</topic><topic>Asthma in children</topic><topic>Attrition (Research Studies)</topic><topic>Birth Weight</topic><topic>Bronchiolitis</topic><topic>Bronchiolitis - complications</topic><topic>Bronchiolitis - epidemiology</topic><topic>Bronchiolitis - therapy</topic><topic>Bronchitis</topic><topic>Cerebral Palsy</topic><topic>Child, Preschool</topic><topic>Childhood asthma</topic><topic>Company business management</topic><topic>Down Syndrome</topic><topic>England - epidemiology</topic><topic>Hospital admission and discharge</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitalization - trends</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Intensive Care Units, Pediatric - statistics & numerical data</topic><topic>Intensive Care Units, Pediatric - trends</topic><topic>Linked Data</topic><topic>Local government</topic><topic>Management</topic><topic>Maternal Age</topic><topic>Medical Record Linkage</topic><topic>Methods</topic><topic>Mortality</topic><topic>Original</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Patient Admission - trends</topic><topic>Patient admissions</topic><topic>Pediatric intensive care units</topic><topic>Physicians</topic><topic>Place of Residence</topic><topic>Population</topic><topic>Respiratory syncytial virus</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Smoking - epidemiology</topic><topic>Social Class</topic><topic>Trend Analysis</topic><topic>Trends</topic><topic>Ventilation</topic><topic>Young Adult</topic><topic>Young Children</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Green, Christopher A</creatorcontrib><creatorcontrib>Yeates, David</creatorcontrib><creatorcontrib>Goldacre, Allie</creatorcontrib><creatorcontrib>Sande, Charles</creatorcontrib><creatorcontrib>Parslow, Roger C</creatorcontrib><creatorcontrib>McShane, Philip</creatorcontrib><creatorcontrib>Pollard, Andrew J</creatorcontrib><creatorcontrib>Goldacre, Michael J</creatorcontrib><collection>British Medical Journal Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Green, Christopher A</au><au>Yeates, David</au><au>Goldacre, Allie</au><au>Sande, Charles</au><au>Parslow, Roger C</au><au>McShane, Philip</au><au>Pollard, Andrew J</au><au>Goldacre, Michael J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>101</volume><issue>2</issue><spage>140</spage><epage>146</epage><pages>140-146</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>BackgroundAdmission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistics (HES, 1989–2011), Oxford Record Linkage Study (ORLS, 1963–2011) and Paediatric Intensive Care Audit Network (PICANet, 2003–2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.ResultsAll-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged <1 year between 1979 and 2011. In 2011 the estimated annual hospital admission rate was 46.1 (95% CI 45.6 to 46.6) per 1000 infants aged <1 year. Between 2004 and 2011 the rates rose by an average of 1.8% per year in the all-England HES data, whereas admission rates to paediatric intensive care changed little (1.3 to 1.6 per 1000 infants aged <1 year). A fivefold geographical variation in hospital admission rates was observed. Young maternal age, low social class, low birth weight and maternal smoking were among factors associated with an increased risk of hospital admission with bronchiolitis.ConclusionsHospital admissions for infants with bronchiolitis have increased substantially in recent years. However, cases requiring intensive care have changed little since 2004.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>26342094</pmid><doi>10.1136/archdischild-2015-308723</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Admission and discharge Adolescent Adult Analysis Asthma Asthma - epidemiology Asthma - etiology Asthma in children Attrition (Research Studies) Birth Weight Bronchiolitis Bronchiolitis - complications Bronchiolitis - epidemiology Bronchiolitis - therapy Bronchitis Cerebral Palsy Child, Preschool Childhood asthma Company business management Down Syndrome England - epidemiology Hospital admission and discharge Hospitalization - statistics & numerical data Hospitalization - trends Hospitals Humans Infant Infant, Newborn Infants Infections Intensive care Intensive Care Units, Pediatric - statistics & numerical data Intensive Care Units, Pediatric - trends Linked Data Local government Management Maternal Age Medical Record Linkage Methods Mortality Original Patient Admission - statistics & numerical data Patient Admission - trends Patient admissions Pediatric intensive care units Physicians Place of Residence Population Respiratory syncytial virus Risk Factors Smoking - adverse effects Smoking - epidemiology Social Class Trend Analysis Trends Ventilation Young Adult Young Children |
| title | Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma |
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