Changes in risk of hospital readmission among asthmatic children in Denmark, 1978-93
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7204.229 (Published 24 July 1999) Cite this as: BMJ 1999;319:229All rapid responses
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Editor,
The decrease in hospital re-admission rates among the Danish
asthmatic children during 1978 - 93 period is welcome news (1). However,
we have concerns about the criteria for hospital re-admission used by the
authors. More specifically, they did not include the children re-admitted
with acute exacerbation of asthma within 12 months of the index admission.
This is important since Mitchell et al (2) have previously reported that a
third of asthmatic children are re-admitted within 6 months while nearly
half of them were re-admitted within the 12 months of index admission.
Whilst it is possible that the decrease in hospital re-admission also
occured within 12 months after the index admission, it is important that
the authors should have provided these data.
References:
1 Bisgaard H, Moller H. Changes in risk of hospital readmission among
asthmatic children in Denmark, 1978 - 93. BMJ 1999; 319:229-30
2 Mitchell EA, Bland JM, Thompson JMD. Risk factors for readmission to
hospital for asthma in childhood. Thorax 1994; 49:33-36
Ravi Agarwal & Zulf Mughal
Department of Paediatric Medicine,
Saint Mary's Hospital for Women & Children,
Hathersage Road,
Manchester
M13 0DQ
Competing interests: No competing interests
Response to Dr Agarwal
Editor
We have reported a decrease in re-admission rate for children aged 5-14
years with asthma. Re-admission was arbitrarily defined as any admission
occurring more than 12 month after the first admission. This served to
increase the specificity of the asthma diagnosis.
Dr Ravi Agarwal expresses concern over this criteria, since many children
are re-admitted within 12 month of their first admission.
We agree that many children are re-admitted within the first year of the
first admission. However, we fail to see how this could affect the
conclusion of our data, that the risk of re-admission has decreased
significantly during the observed period.
Sincerely,
Hans Bisgaard
Professor of Paediatrics
Copenhagen University Hospital,
Rigshospitalet,
DK-2100 Copenhagen,
Denmark
Competing interests: No competing interests