Determinants of Health Care Utilization for Respiratory Symptoms in the First Year of Life

Jong, Brita M. de; Ent, Cornelis K. van der; Katier, Nienke; Zalm, Marieke M. van der; Verheij, Theo; Kimpen, Jan L. L.; Numans, Mattijs E.; Uiterwaal, Cuno S.P.M.

doi:10.1097/mlr.0b013e3180546879

Cited by 25 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although in a previous article [21] we described that consultations are not only associated with severity of symptoms, the same results were found after adjustment for risk factors associated with consultations for respiratory illnesses. Although there is standardisation in primary care, as all general practitioners use ICPC, it is possible that different general practitioners classified wheezing illnesses in a different way.…”

Section: Discussionsupporting

confidence: 68%

“…The models were adjusted for maternal smoke exposure during pregnancy, parental allergy and the presence of siblings, because these variables may be associated with lung function and wheezing illnesses. Because we have previously showed that daycare visits, ethnicity and maternal age .30 years are determinants of consultations for respiratory illnesses [21], we also adjusted the regression analyses with consultations or asthma as outcome for these potential confounders, additionally to the above-mentioned variables. The linear regression model was additionally adjusted for length and weight at the spirometry measurement.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

et al. 2012

Self Cite

View full text Add to dashboard Cite

Studies of reduced neonatal lung function and wheezing illnesses during childhood show conflicting results. The aim of our study was to assess the association between resistance (Rrs) and compliance (Crs) of the respiratory system by using the single occlusion technique (SOT) and prospectively collected wheezing illnesses during the first 5 years of life in a large birth cohort.SOT was performed during natural sleep before the age of 2 months. Information about wheezing illnesses was collected from the electronic patient file.549 infants had a successful SOT measurement and complete medical records. Every kPa?L -1 ?s -1 increase in Rrs was associated with 10% more consultations in the first 3 years of life. Every 10 mL?kPa -1 increase in Crs was associated with a 14% reduction in consultations in the first 3 years of life, 27% in the fourth to fifth years of life, and a lower probability of having asthma at the age of 5 years (OR 0.66). Children with lateonset or persistent wheezing had significant lower Crs values than their peers.An increased neonatal resistance is associated with more wheezing illnesses during infancy, while a reduced neonatal compliance is associated with more wheezing illnesses during the first 5 years of life, a late-onset or persistent wheezing phenotype, and asthma. @ERSpublications Increased neonatal resistance and reduced neonatal compliance are both associated with more wheezing illnesses

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…These fi ndings are in line with reports of genetic infl uence on disease susceptibility, 8 health-seeking behavior, 7,25 and the attitude of the caregivers or parents regarding medication use. 26 In our study, we found that parental asthma was positively associated with prescribing asthma medications.…”

Section: Family Infl Uencesupporting

confidence: 77%

What Drives Prescribing of Asthma Medication to Children? A Multilevel Population-Based Study

Zuidgeest¹,

Dijk²,

Spreeuwenberg³

et al. 2009

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSE Diagnosing asthma in children with asthmatic symptoms remains a challenge, particularly in preschool children. This challenge creates an opportunity for variability in prescribing. The aim of our study was to investigate how and to what degree patient, family, and physician characteristics infl uence prescribing of asthma medication in children. METHODSWe undertook a multilevel population-based study using the second Dutch national survey of general practice (DNSGP-2), 2001. Participants were 46,371 children aged 1 to 17 years belonging to 25,537 families registered with 109 general practitioners. Using a multilevel multivariate logistic regression analysis with 3 levels, our main outcome measure was the prescribing of asthma medication, defi ned as at least 1 prescription for β 2 -adrenergic agonists, inhaled corticosteroids, cromones, or montelukast during the 1-year study period. RESULTSWe identifi ed characteristics signifi cantly associated with prescribing asthma medication on all 3 levels (child, family, and physician). The variance in prescribing among physicians was signifi cantly higher with children who were younger than 6 years than with children aged 6 years and older (95% CI, 3.5%-25.2% vs 2.4%-13.4%). Several diagnoses other than asthma and asthmatic complaints were strongly associated with prescribing asthma medication, including bronchitis/bronchiolitis (OR = 9.04; 95% CI, 7.57-10.8) and cough (OR = 6.51; 95% CI,).CONCLUSIONS Our study shows a much higher variance in prescribing patterns among general practitioners for children younger than 6 years compared with older children, which could be a direct result of the diagnostic complexities found in young children with asthmatic symptoms. Thus diagnostic gaps may lead to more physician-driven prescribing irrespective of the clinical context.

show abstract

“…It is well recognised that RW in infants significantly affects the quality of life of patients and their families1 and represents an important cause for using healthcare resources, thus resulting in a large health economic impact 2 3. In a prevalence study in young children aged 1–5 years from the USA and Europe, it was found that one-third of them suffered from recurrent asthma-like symptoms 4.…”

Section: Introductionmentioning

confidence: 99%

International prevalence of recurrent wheezing during the first year of life: variability, treatment patterns and use of health resources

Mallol

García‐Marcos

Solé

et al. 2010

Thorax

152

136

View full text Add to dashboard Cite

Background Recurrent wheezing (RW) during the first year of life is a major cause of respiratory morbidity worldwide, yet there are no studies on its prevalence at an international level. A study was undertaken to determine the prevalence of RW in infants during their first year of life in affluent and non-affluent localities. Methods This international population-based study was performed in random samples of infants aged 12e15 months from 17 centres in Latin America and Europe. It uses a validated questionnaire answered by parents at the primary care health clinics where infants attend for growth/development monitoring and/or vaccine administration. Results Among the 30 093 infants surveyed, 45.2% (95% CI 44.7% to 45.8%) had at least one episode of wheezing and 20.3% (95% CI 19.8% to 20.7%) had RW. The mean prevalence of RW in Latin American and European centres was 21.4% (95% CI 20.9% to 21.9%) and 15.0% (95% CI 14.0% to 15.9%), respectively (p<0.001). There was significant morbidity associated with RW in terms of severe episodes (59.4%), visits to the emergency department (71.1%) and hospital admissions (26.8%); 46.1% used inhaled corticosteroids. Conclusions The prevalence of RW in infants during the first year of life is high and varies between localities. A significant proportion of infants progress to a more severe condition which results in high use of health resources (visits to emergency department and hospitalisations). The prevalence of RW is lower and less severe in European than in Latin American centres, suggesting there is a higher risk for the disease in developing areas.

show abstract

Determinants of Health Care Utilization for Respiratory Symptoms in the First Year of Life

Abstract: Child and parent characteristics, besides complaints per se, play an important role in health care utilization for respiratory illnesses in infancy.

Cited by 25 publications

References 19 publications

Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

What Drives Prescribing of Asthma Medication to Children? A Multilevel Population-Based Study

International prevalence of recurrent wheezing during the first year of life: variability, treatment patterns and use of health resources

Contact Info

Product

Resources

About