Hyndman S J, Williams D R, Merrill S L, Lipscombe J M, Palmer C R
University Department of Community Medicine, University of Cambridge.
BMJ. 1994 Jun 18;308(6944):1596-600. doi: 10.1136/bmj.308.6944.1596.
To describe trends in hospital admission rates for asthma in England and Wales (1976-85), the East Anglian region (from 1976 to 1991-2), and Wales (1980-90).
Descriptive study.
Hospitals in England and Wales; hospitals in the East Anglian Regional Health Authority; hospitals in Wales.
Hospital admissions for asthma as principal diagnosis in England and Wales (Hospital In-patient Enquiry, 1976-85), for the East Anglian region (Hospital In-patient Enquiry, 1976-7; Hospital Activity Analysis, 1978-86; Regional Information System, 1987-8 to 1991-2), and for Wales (Hospital Activity Analysis, 1980-90).
Rates for England and Wales as a whole showed a steady upward trend throughout the period examined. Rates in East Anglia, though they were similar to the national trends in the early years, showed a peak in 1985 (for males and females) with some indication of a decline in rates thereafter. Rates for Wales showed an upward trend until 1988 (for both males and females) after which they showed a decline.
Interpretation of the East Anglian trends is made more difficult by the change in England in 1987 of the system for the collection of hospital admission data. The fact that the rates for the East Anglian region seem to decline before this change and other considerations suggest that the observed trends, although partly reflecting the disruption of the coding during the changeover in systems, may not be entirely artefactual. The possible roles of diagnostic transfer and changes in the delivery of care, asthma treatment, admission and readmission policies, and the severity and prevalence of asthma in changing admission rates are considered. The changing trends in admission rates for East Anglia and Wales reflect recently published trends for mortality from asthma in England.
描述英格兰和威尔士（1976 - 1985年）、东安格利亚地区（1976年至1991 - 2年）以及威尔士（1980 - 1990年）哮喘住院率的趋势。
描述性研究。
英格兰和威尔士的医院；东安格利亚地区卫生局的医院；威尔士的医院。
在英格兰和威尔士，以哮喘作为主要诊断的住院情况（医院住院病人调查，1976 - 1985年）；在东安格利亚地区，以哮喘作为主要诊断的住院情况（医院住院病人调查，1976 - 197年；医院活动分析，1978 - 1986年；区域信息系统，1987 - 8年至1991 - 2年）；在威尔士，以哮喘作为主要诊断的住院情况（医院活动分析，1980 - 1990年）。
在整个研究期间，英格兰和威尔士总体的哮喘住院率呈稳步上升趋势。东安格利亚地区的住院率在早期虽与全国趋势相似，但在1985年（男性和女性）出现峰值，此后有下降迹象。威尔士的住院率在1988年（男性和女性）之前呈上升趋势，之后则下降。
1987年英格兰医院住院数据收集系统的变化使东安格利亚地区趋势的解读变得更加困难。东安格利亚地区的住院率在这一变化之前似乎就已下降，以及其他一些因素表明，观察到的趋势虽然部分反映了系统转换期间编码的混乱，但可能并非完全是人为造成的。文中考虑了诊断转移、护理提供方式的变化、哮喘治疗、住院和再住院政策以及哮喘的严重程度和患病率在改变住院率方面可能起到的作用。东安格利亚地区和威尔士住院率的变化趋势反映了最近公布的英格兰哮喘死亡率趋势。
