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Admissions with bronchiolitis
Admissions with bronchiolitis during the ‘season’ are a considerable burden to the overall paediatric health care resource. Green and colleagues report on the changes in hospital admission rates over the last 50 years. This is by analysis of multiple different recording systems including Hospital Inpatient Enquiry (1968–85), Hospital Episode Statistics (1989–2011), Oxford Record Linkage Study (1963–2011) and Paediatric Intensive Care Audit Network (2003–12). The data shows a seven fold increase since bronchiolitis was given a separate discharge code in 1979 from 6.6 to 46.1 episodes per 1000 infants aged less than 1, whereas admissions to paediatric intensive care units (PICU) rose only a little (1.3 to 1.6 infants per 1000 infants aged less than 1 year; 2004–11). The variation in geographical admission rates was five-fold with risk factors for admission including young maternal age, low social class, low birth weight and maternal smoking. There are many potential factors that could at least partially explain this which are discussed in the paper including changes in how emergency care is delivered, changes in how the hospital admission criteria are recorded, lowered thresholds for admission, increase in accuracy of discharge diagnosis, increasing prevalence of risk factors including the improvements in survival of infants born preterm. Disease severity is …
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