Asthma hospitalisation trends from 2010 to 2015: variation among rural and metropolitan Australians

Abstract

BackgroundAsthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993–94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010–2015 results with asthma data prior to 2010.MethodsHospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables.ResultsDuring the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0–14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0–14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas.ConclusionsWe demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient’s age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour.

Milk Other than Breast Milk and the Development of Asthma in Children 3 Years of Age. A Birth Cohort Study (2006-2011)

“…This finding is consistent with previous studies carried out in Denmark and Sweden which showed that breastfeeding does not lower the risk of childhood asthma (OR: 1.08, 95% CI: 0.93-1.25) and (OR: 0.99, 95% CI: 0.96-1.02) respectively [47,48] Mode of delivery, gender, maternal and household smoking as well as maternal asthma are potential risk factors for asthma in children as demonstrated by several studies [49][50][51][52][53][54]. Gender appears to be a factor in the development of asthma, where boys in general are reported to have more severe asthma than girls [50] and higher rates of admission to hospitals [52,55]. Researchers have attributed this to airway hyper-responsiveness in childhood that is more common and more severe among males than females.…”

Acute circulatory complications in people with diabetes mellitus type 2: How admission varies between urban and rural Victoria

“…Lastly, the Accessibility and Remoteness Index of Australia 2011 (ARIA+) was also used. The ARIA+ measures the level of geographical remoteness of LGA by examining the road distance to goods and services with respect to population size; the key data sources outlined provided the specific LGA measures required for data analysis . The mean ARIA+ scores were used for each individual LGA and were scored as ‘highly accessible’ (0–0.2), ‘accessible’ (0.2–2.4) and ‘moderately accessible’ (2.4–5.92) …”

Factors contributing to COPD hospitalisations from 2010 to 2015: Variation among rural and metropolitan Australians

“…Hospitalisation data for a five-year period from July 1, 2010 to June 30, 2015 were obtained from the Victorian Admitted Episodes Dataset (VAED). As discussed elsewhere, 16 data included sex, age (five-year age groups), LGA or region of residence, private or public patient, bed days used as the unit of measurement for length of stay, type of discharge and diagnosis on hospitalisation according the ICD-10-AM. COPD as the principal diagnosis was identified using the ICD-10-AM codes J43.1, J43.2, J43.8, J43.9, J44.0, J44.1, J44.8 and J44.9.…”

“…Ethical approval for the research was obtained in March 2015. Others sources of data were included as outlined previously, 16 and were sourced from the Australian Bureau of Statistics. 17…”