Outcomes of young children hospitalized with acute wheezing.

BACKGROUND: Wheezing in preschool children is a common symptom. OBJECTIVE: The study aimed to determine an incidence of recurrent wheezing among young children who had been hospitalized with acute wheezing after 12 months. Factors associated with recurrent wheezing were explored. METHODS: A longitudinal study was conducted among 236 children, aged between 6 months and 5 years, who were hospitalized with acute wheezing in 4 hospitals located in Bangkok and adjacent provinces, Thailand. Demographics, house environments and clinical characteristic data were collected at entry. Serum specific IgE levels against common food and inhalant allergens and serum 25-hydroxyvitamin D (25OHD) concentrations were measured. RESULTS: At entry, the mean age was 24.4 months (SD = 15.7 months). Of 236 hospitalized children with acute wheezing, ninety-four cases (39.8%) were the first wheezing episode of life. By laboratory results, 197 (83.5%) and 56 (23.7%) children were atopic and had vitamin D insufficiency respectively. There were 195 cases completely followed for 12 months. One-year risk of emergency visits and hospitalization due to recurrent wheezing were 49.7% and 23.1% respectively. By multivariable analysis, being the second born child or more, vitamin D insufficiency, "ever wheeze", and allergic rhinitis were significantly associated with recurrent wheezing within 12 months with adjusted odds ratios of 2.5 (95% confidence interval: 1.3-5.3), 2.3 (95% confidence interval: 1.1-4.4), 1.9 (95% confidence interval: 1.2-3.5), and 1.6 (95% confidence interval: 1.3-2.9) respectively. CONCLUSIONS: Being the second born child or more, vitamin D insufficiency, ever wheeze, and allergic rhinitis were significant risks of recurrent wheezing.

Economic Burden of Hospitalization with Acute Wheezing in Preschool Children: A Multi-Center Study.

Background: Wheezing is an important health problem in Thailand especially among preschool age. Objective: The aim of this study was to estimate costs of wheezing for hospitalization in preschool children under patient, provider, and societal perspectives. Material and Method: Two hundred and thirty-four participants who were admitted with acute wheezing at 4 hospitals including Thammasat University Hospital, Saraburi Hospital, Bhumibol Adulyadej Hospital and King Chulalongkorn Memorial Hospital during July 2014 to June 2015 were included in the present study. Data from hospital financial database and caregivers' expenses were collected. Cost-to-charge ratio method was employed for valuation of direct medical costs. Informal care costs were determined by human capital approach. Results: The means of patient, provider and societal costs per admission were 3,020 THB (SD = 6,632 THB), 18,126 THB (SD = 16,898 THB), and 20,269 THB (SD = 20,537 THB) respectively. The main cost component in provider and societal perspective were accommodation costs during admission. Informal care cost was a major cost component for direct nonmedical costs. The economic burden of acute wheezing admission of preschool children in Thailand was estimated as 759 million THB per year. Conclusion: These costs of illness analysis provided an evidence of economic burden and costs of preschool wheezing in hospitalization in Thailand.