Child/Adolescent Health

Bronchiolitis-related outpatient and hospital visits have risen markedly among Medicaid-insured infants in Tennessee

The number of Medicaid-insured infants in Tennessee seeking medical care for bronchiolitis has risen markedly, reveals a new study. Bronchiolitis is a lower respiratory tract infection caused by respiratory syncytial virus (RSV) and other viruses. The infection causes coughing, wheezing, abnormally rapid breathing, and/or rales (crackling sounds that indicate fluid in the air sacs of the lungs). RSV infects most children in the first year of life and typically causes yearly epidemics of bronchiolitis between November and April, resulting in about 80,000 infant hospitalizations per year.

Although the majority of infants affected are generally healthy, younger maternal age and lower birth weight are risk factors, explain the researchers. They retrospectively studied 103,670 term, non-low-birth weight infants enrolled in Tennessee Medicaid from 1995-2003, and identified their health care visits for bronchiolitis in the first year of life. The researchers examined risk factors for bronchiolitis during infancy and rates of various types of health care for the disease.

During the 9-year study period, rates of bronchiolitis visits were 238 outpatient visits, 77 emergency department (ED) visits, and 71 hospitalizations per 1,000 infant-years. However, average annual rates for bronchiolitis visits jumped 41 percent, from 188 visits per 1,000 infant-years to 265 visits per 1,000 infant-years from 1996-1997 to 2002-2003. Compared with infants of mothers 20 to 29 years of age, infants of mothers 15 to 19 years of age had a small increased risk of having a bronchiolitis visit, whereas infants of older mothers (30-39 and 40-44) were less likely to have a visit for the illness. Higher infant birth weight was another protective factor.

The study was supported in part by the Agency for Healthcare Research and Quality (HS10384).

See "Increasing burden and risk factors for bronchiolitis-related medical visits in infants enrolled in a state health care insurance plan," by Kecia N. Carroll, M.D., M.P.H., Tebeb Gebretsadik, M.P.H., Marie R. Griffin, M.D., M.P.H., and others in the July 2008 Pediatrics 122, pp. 58-64.

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