Hospital admissions for childhood asthma in Rogaland, Norway, from 1984 to 2000

Aim: The prevalence of childhood asthma is increasing, and it is important to monitor factors related to hospital admissions in order to understand the different aspects of the disease. The aim of this study was to investigate admissions for childhood asthma to Rogaland Central Hospital, Norway, in order to elucidate time trends related to rates of admissions and treatment modalities. Methods: A population-based study was conducted in which data extracted from the medical records, including number of admissions, length of hospitalization, medication and symptom scores, were recorded for children aged 1 to 14 y admitted to hospital for asthma during four periods, of two years each, from 1984/1985 to 1999/2000. Results: For all the children there was an increase in annual admission rates for asthma from 1984/1985 to 1989/1990 and stabilization thereafter, but there were substantial differences between age groups. For children of 1 or 2 y of age the annual admission rate increased from 43/10000 in the first period to 104/10000 in the last period (p < 0.001), with an increase in both primary admissions and re-admissions. For children aged 3 and 4 y, the admission rates increased from the first to the second period, and then declined to an annual admission rate of 40/10000 in 1999/2000. For older children, the admission rate was low and stable. There was a gradual increase in the use of inhaled corticosteroids both prior to admission and at discharge, and the percentage of children receiving systemic corticosteroids at admission increased from 19% to 45% (p < 0.001). The average hospital in-days decreased from 3.4 to 1.9 (p < 0.001). Conclusion: A disturbingly high and increasing rate of both primary admissions and readmissions for asthma has been observed in children aged I and 2 y, which seemed to be unaffected by changes in treatment modalities during the period. The decrease in admissions for children aged 3 and 4 y may have been influenced by the increased use of inhaled corticosteroids.