Kohei Hasegawa1, Yusuke Tsugawa, David F M Brown, Jonathan M Mansbach, Carlos A Camargo. 1. From the *Massachusetts General Hospital; †Harvard Medical School; ‡Beth Israel Deaconess Medical Center, Boston, MA; §Center for Clinical Epidemiology of St. Luke's Life Science Institute, Tokyo, Japan; and ¶Boston Children's Hospital, Boston, MA.
Abstract
BACKGROUND: To examine temporal trends in emergency departments (EDs) visits for bronchiolitis among US children between 2006 and 2010. METHODS: Serial, cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We used International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1 to identify children <2 years of age with bronchiolitis. Primary outcome measures were rate of bronchiolitis ED visits, hospital admission rate and ED charges. RESULTS: Between 2006 and 2010, weighted national discharge data included 1,435,110 ED visits with bronchiolitis. There was a modest increase in the rate of bronchiolitis ED visits, from 35.6 to 36.3 per 1000 person-years (2% increase; Ptrend = 0.008), due to increases in the ED visit rate among children from 12 months to 23 months (24% increase;Ptrend < 0.001). By contrast, there was a significant decline in the ED visit rate among infants (4% decrease; Ptrend < 0.001). Although unadjusted admission rate did not change between 2006 and 2010 (26% in both years), admission rate declined significantly after adjusting for potential patient- and ED-level confounders (adjusted odds ratio for comparison of 2010 with 2006, 0.84; 95% confidence interval: 0.76-0.93; P < 0.001). Nationwide ED charges for bronchiolitis increased from $337 million to $389 million (16% increase; Ptrend < 0.001), adjusted for inflation. This increase was driven by a rise in geometric mean of ED charges per case from $887 to $1059 (19% increase; Ptrend < 0.001). CONCLUSIONS: Between 2006 and 2010, we found a divergent temporal trend in the rate of bronchiolitis ED visits by age group. Despite a significant increase in associated ED charges, ED-associated hospital admission rates for bronchiolitis significantly decreased over this same period.
BACKGROUND: To examine temporal trends in emergency departments (EDs) visits for bronchiolitis among US children between 2006 and 2010. METHODS: Serial, cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We used International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1 to identify children <2 years of age with bronchiolitis. Primary outcome measures were rate of bronchiolitis ED visits, hospital admission rate and ED charges. RESULTS: Between 2006 and 2010, weighted national discharge data included 1,435,110 ED visits with bronchiolitis. There was a modest increase in the rate of bronchiolitis ED visits, from 35.6 to 36.3 per 1000 person-years (2% increase; Ptrend = 0.008), due to increases in the ED visit rate among children from 12 months to 23 months (24% increase;Ptrend < 0.001). By contrast, there was a significant decline in the ED visit rate among infants (4% decrease; Ptrend < 0.001). Although unadjusted admission rate did not change between 2006 and 2010 (26% in both years), admission rate declined significantly after adjusting for potential patient- and ED-level confounders (adjusted odds ratio for comparison of 2010 with 2006, 0.84; 95% confidence interval: 0.76-0.93; P < 0.001). Nationwide ED charges for bronchiolitis increased from $337 million to $389 million (16% increase; Ptrend < 0.001), adjusted for inflation. This increase was driven by a rise in geometric mean of ED charges per case from $887 to $1059 (19% increase; Ptrend < 0.001). CONCLUSIONS: Between 2006 and 2010, we found a divergent temporal trend in the rate of bronchiolitis ED visits by age group. Despite a significant increase in associated ED charges, ED-associated hospital admission rates for bronchiolitis significantly decreased over this same period.
Authors: Deborah A Levine; Shari L Platt; Peter S Dayan; Charles G Macias; Joseph J Zorc; William Krief; Jeffrey Schor; David Bank; Nancy Fefferman; Kathy N Shaw; Nathan Kuppermann Journal: Pediatrics Date: 2004-06 Impact factor: 7.124
Authors: Robert C Holman; Aaron T Curns; James E Cheek; Joseph S Bresee; Rosalyn J Singleton; Karen Carver; Larry J Anderson Journal: Pediatrics Date: 2004-10 Impact factor: 7.124
Authors: Amy C Plint; David W Johnson; Natasha Wiebe; Blake Bulloch; Martin Pusic; Gary Joubert; Paul Pianosi; Troy Turner; Graham Thompson; Terry P Klassen Journal: Acad Emerg Med Date: 2004-04 Impact factor: 3.451
Authors: Kohei Hasegawa; Rachel W Linnemann; Jonathan M Mansbach; Nadim J Ajami; Janice A Espinola; Joseph F Petrosino; Pedro A Piedra; Michelle D Stevenson; Ashley F Sullivan; Amy D Thompson; Carlos A Camargo Journal: Pediatrics Date: 2016-07 Impact factor: 7.124
Authors: Sze Man Tse; Sheryl L Rifas-Shiman; Brent A Coull; Augusto A Litonjua; Emily Oken; Diane R Gold Journal: J Allergy Clin Immunol Date: 2016-04-27 Impact factor: 10.793
Authors: Michimasa Fujiogi; Tadahiro Goto; Hideo Yasunaga; Jun Fujishiro; Jonathan M Mansbach; Carlos A Camargo; Kohei Hasegawa Journal: Pediatrics Date: 2019-11-07 Impact factor: 7.124
Authors: Kohei Hasegawa; Rachel W Linnemann; Jonathan M Mansbach; Nadim J Ajami; Janice A Espinola; Joseph F Petrosino; Pedro A Piedra; Michelle D Stevenson; Ashley F Sullivan; Amy D Thompson; Carlos A Camargo Journal: Pediatr Infect Dis J Date: 2017-11 Impact factor: 2.129
Authors: Kohei Hasegawa; Jonathan M Mansbach; Nadim J Ajami; Janice A Espinola; David M Henke; Joseph F Petrosino; Pedro A Piedra; Chad A Shaw; Ashley F Sullivan; Carlos A Camargo Journal: Eur Respir J Date: 2016-10-06 Impact factor: 16.671
Authors: Kohei Hasegawa; Jonathan M Mansbach; Stephen J Teach; Erin S Fisher; Daniel Hershey; Joyce Y Koh; Sunday Clark; Pedro A Piedra; Ashley F Sullivan; Carlos A Camargo Journal: Pediatr Infect Dis J Date: 2014-08 Impact factor: 2.129