Department of Obstetrics-Gynecology and Peadiatrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal.
Department of Community Medicine, Information and Health Decision Sciences - MEDCIDS, Faculty of Medicine, Universidade do Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, Universidade do Porto, Porto, Portugal.
Pulmonology. 2019 May-Jun;25(3):154-161. doi: 10.1016/j.pulmoe.2018.05.002. Epub 2018 Jun 10.
Recent studies show contradictory data on the incidence of hospitalizations for acute bronchiolitis (AB) and an escalating increase in public health burden.
We aimed to analyze the population-based admission rate for AB in children under 2 years of age, in Portuguese public hospitals, from 2000 to 2015, to assess trends and regional variations in admission rate; outcomes; associated direct health-care costs; and changes in management after the implementation of national guidelines.
Retrospective observational study, conducted using a Portuguese administrative database, which contains all registered public hospitalizations in mainland Portugal, and demographic data from the National Statistics Institute.
Over the study period, we recorded 80,491 admissions for AB. The mean admission rate was 26.28 and was higher in the northernmost regions of the country. Along the time, the admission rate rose by an average of 1.6% per year (3.8% in children younger than 3 months) and the average length of stay (LOS) was 6.1 days and decreased, to a minimum of 5.5 days in 2014. The in-hospital mortality rate (0.1%) and the use of invasive ventilation remained stable, but non-invasive ventilation use increased from 0.4% in 2000 to 4% in 2015. The direct estimated total costs were of 72,420,732€. In recent years, there was a decrease in the reported tests and procedures.
AB remains a major burden in the healthcare system. The admission rate increased but does not seem to be due to an increase in severity, as LOS decreased, and the use of invasive ventilation and mortality remained unchanged.
最近的研究显示，急性细支气管炎（AB）住院的发病率存在矛盾的数据，公共卫生负担也在不断增加。
我们旨在分析 2000 年至 2015 年期间，葡萄牙公立医院 2 岁以下儿童因 AB 住院的人群发病率，评估入院率的趋势和地区差异；结局；相关直接医疗保健费用；以及国家指南实施后管理的变化。
这是一项回顾性观察性研究，使用葡萄牙行政数据库进行，该数据库包含葡萄牙大陆所有登记的公立医院住院记录和国家统计局的人口统计学数据。
在研究期间，我们记录了 80491 例 AB 住院。平均入院率为 26.28%，北部地区的入院率更高。随着时间的推移，入院率平均每年增加 1.6%（3 个月以下儿童为 3.8%），平均住院时间（LOS）为 6.1 天，并减少，2014 年最低为 5.5 天。院内死亡率（0.1%）和使用有创通气保持稳定，但无创通气的使用从 2000 年的 0.4%增加到 2015 年的 4%。直接估计的总费用为 72420732 欧元。近年来，报告的检查和程序有所减少。
AB 仍然是医疗保健系统的主要负担。入院率增加，但似乎不是由于严重程度增加所致，因为 LOS 减少，而使用有创通气和死亡率保持不变。
