Changing patterns of asthma hospitalization among children: 1979 to 1987.

The National Hospital Discharge Survey was used to evaluate the trends in asthma hospitalizations among children under International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): 1979 to 1987. During this period, asthma hospitalizations among children aged 0 to 17 years increased 4.5% per annum (95% confidence interval [Cl], 2% to 7.1%). The increase was largest among 0 to 4 year olds, 5.0% per annum (95% Cl, 3.4% to 6.7%), vs 2.9% per annum (95% Cl, -0.3% to 6.2%) observed among 5 to 17 year olds. Among children aged 0 to 4 years, blacks had approximately 1.8 times the increase of whites. During this time, total hospitalizations decreased -4.6% (95% Cl, -6.6% to -2.5%), while admissions for lower respiratory tract disease had a statistically insignificant decrease: -1.3%. Acute and chronic/unspecified bronchitis hospitalizations decreased -6.1% (95% Cl, -9.4% to -2.7%), but this decrease did not begin until 1983. Thus, a shift in coding from bronchitis to asthma does not seem to fully explain the increase.