Spencer N J, Lewis M A
Northern General Hospital, Sheffield.
Arch Dis Child. 1991 Aug;66(8):938-40. doi: 10.1136/adc.66.8.938.
Hospital admission rates before 2 years of age are reported for two complete birth cohorts born within a geographically defined area five years apart in 1980 and 1985. Admission rates for individual children in the cohort before 2 years of age showed an increase between 1980 and 1985 from 209 to 247 children/1000. The most significant increase took place in those children admitted three or more times (multiple admissions). Children admitted once only increased significantly but there was no significant change in the number of children admitted twice. A total of 2.3% of the total cohort in 1980 and 3.6% in 1985 were admitted three or more times and accounted for over 30% of all admissions. Age specific rates are reported for the 1985 cohort; 36% of those admitted had their first admission before 3 months of age and 76% before their first birthday. The disproportionate contribution of children with multiple admissions to the admissions total renders admission data from Hospital Activities Analysis invalid unless linked to individual children. Cohort data based on a geographically defined population provide the most reliable admission rates and permit an accurate analysis of trends. The significance of and reasons for the upward trend in early childhood admissions are discussed.
报告了1980年和1985年在一个地理区域内相隔五年出生的两个完整出生队列在2岁前的住院率。该队列中2岁前个体儿童的住院率在1980年至1985年间从每1000名儿童209例增加到247例。增幅最大的是那些住院三次或更多次(多次住院)的儿童。仅住院一次的儿童显著增加,但住院两次的儿童数量没有显著变化。1980年队列总数的2.3%和1985年的3.6%住院三次或更多次,占所有住院人数的3%以上。报告了1985年队列的年龄别住院率;36%的住院儿童在3个月前首次住院,76%在周岁前首次住院。多次住院儿童对总住院人数的不成比例贡献使得医院活动分析的住院数据无效,除非与个体儿童相关联。基于地理定义人群的队列数据提供了最可靠的住院率,并允许对趋势进行准确分析。讨论了幼儿住院率上升趋势的意义和原因。