Van Dole Kristen B, Swern Arlene S, Newcomb Kathleen, Nelsen Linda
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA.
Ann Allergy Asthma Immunol. 2009 Mar;102(3):198-204. doi: 10.1016/S1081-1206(10)60081-6.
In children, hospitalization for asthma is reported to have a distinct seasonal pattern with peaks coincident with the start of school. Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medication use.
To describe seasonal patterns of asthma-related health care use and asthma controller and reliever medication claims in children.
An ecological analysis was conducted of data collected from records for children aged 2 to 12 years from 2002 through 2004 from an automated research database of insurance claims from a large US health care plan. Seasonal patterns for health care use and estimates of prescription asthma controller and reliever use were determined for preschool-aged children (aged 2-5 years) and school-aged children (aged 6-12 years). Rates were constructed by week; deviations from annual mean rates were used to determine peaks in use. Results were confirmed using Poisson regression models, modeling for rates within age group, with factors for week, year, and regions.
Emergency department and outpatient visits and hospitalizations were lowest during summer; rates increased beginning in September, peaking in October or November. Asthma controller and reliever medication claims increased beginning in September, peaking in December. Rates also were elevated in February.
The data suggest that children who reduce their asthma medications during the summer do not resume taking medications until signs or symptoms of asthma worsen. The summer hiatus and other factors may contribute to seasonal increases in health care use and in asthma medication prescriptions, particularly in the fall.
据报道，儿童哮喘住院存在明显的季节性模式，高峰期与开学时间一致。尽管指南指出哮喘控制药物应每日使用，但关于药物实际使用的季节性模式的信息有限。
描述儿童哮喘相关医疗保健使用以及哮喘控制药物和缓解药物索赔的季节性模式。
对2002年至2004年从美国一个大型医疗保健计划的保险索赔自动研究数据库中收集的2至12岁儿童记录数据进行生态分析。确定了学龄前儿童（2至5岁）和学龄儿童（6至12岁）的医疗保健使用季节性模式以及哮喘控制药物和缓解药物使用估计值。按周计算发生率；与年平均发生率的偏差用于确定使用高峰期。使用泊松回归模型进行结果确认，对年龄组内的发生率进行建模，并考虑周、年份和地区等因素。
急诊科就诊、门诊就诊和住院率在夏季最低；从9月开始上升，10月或11月达到峰值。哮喘控制药物和缓解药物索赔从9月开始增加，12月达到峰值。2月的发生率也有所升高。
数据表明，在夏季减少哮喘药物使用的儿童直到哮喘症状恶化才恢复用药。夏季中断及其他因素可能导致医疗保健使用和哮喘药物处方的季节性增加，尤其是在秋季。
