Childhood asthma in New Zealand: the impact of on-going socioeconomic disadvantage (2010-2019).

AIM: To document trends in number and cost of asthma hospital admissions and asthma prescriptions in children (0-14 years) from 2010-2019 in New Zealand. METHOD: A retrospective analysis of public hospital admission and pharmaceutical prescription data. RESULTS: The dataset included 39,731 hospitalisations with asthma as a discharge diagnosis and 5,512,856 prescriptions for asthma medication in children ≤14 years old. From 2010 to 2019, there was a 45% reduction in the number of asthma hospitalisations and an 18% reduction in prescriptions attributable to asthma. Declines were evident for both Maori and non-Maori children. However, Maori children were hospitalised with asthma at twice the rate of non-Maori children (7.2/1,000 versus 3.5/1,000, p<0.001), and a larger proportion of Maori children had an asthma readmission within 90 days of their first admission (18% versus 14%, p <0.001). Asthma admission rates for children from families living in the highest deprivation areas were, on average, 2.8 times higher than in the least deprived areas. We estimate that the combined cost of asthma hospitalisations and prescriptions was $165m. Of this, $103m was for hospital admissions and $62m was for prescriptions. CONCLUSIONS: Although hospitalisations and prescriptions attributable to asthma have declined, there are clear inequities in the health outcomes of New Zealand children with asthma. Our analysis indicates that many New Zealand children, particularly Maori children and those living in areas of high deprivation, are not receiving levels of primary care for asthma that are consistent with prevention.