Clinical Epidemiology (Apr 2022)
Hospital Contacts for Infectious Diseases Among Children in Denmark, Finland, Norway, and Sweden, 2008–2017
Abstract
Lise Gehrt,1,2 Ida Laake,3 Hélène Englund,4 Heta Nieminen,5 Christine Stabell Benn,1,2,6 Berit Feiring,3 Lill Trogstad,3 Arto A Palmu,5 Signe Sørup2,7 1Bandim Health Project, Research Unit Open, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; 2Research Center for Vitamins and Vaccines, Statens Serum Institut, Copenhagen, Denmark; 3Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway; 4Unit for Vaccination Programmes, Public Health Agency of Sweden, Solna, Sweden; 5Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Tampere, Finland; 6Danish Institute for Advanced Study, University of Southern Denmark, Odense C, Denmark; 7Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Lise Gehrt, Bandim Health Project, Research Unit Open, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark, Email [email protected]: Comparing rates of childhood infectious disease hospitalisations across countries may uncover areas for improvement in the prevention of severe childhood infections. We compared rates of childhood infectious disease hospital contacts across Denmark, Finland, Norway, and Sweden with the overall objective to elucidate potential differences in burden of disease and in organisational and registration practices.Methods: Using national registries, we estimated incidence rates for infectious disease hospital contacts between 2008 and 2017 among children aged 0– 14 years. We investigated the rates for different types of contacts (inpatient or outpatient including emergency room), duration of admission, and by sex.Results: During the study period, the rate of all hospital contacts per 1000 person-years was highest in Sweden (125.2) followed by Finland (87.1), Denmark (79.0), and Norway (62.1). The rates aligned for inpatient contacts with overnight stays; 19.3 (Denmark), 16.6 (Finland), 16.3 (Norway), and 13.0 (Sweden); these were highest in early infancy in all countries. A peak around 1 year of age was seen in all countries except in Sweden. The rates were higher among boys compared with girls in early childhood, after 13 years of age the rates among girls surpassed the boys.Conclusion: Large cross-country differences were observed for outpatient and short-term hospital contacts for infectious diseases, affected by differences in organisational structures and coding practices across and within countries over time. Inpatient contacts requiring overnight stays reflected more comparable levels of severe infections across countries. Childhood infectious disease morbidity was greatest among boys and before 2 years of age.Keywords: infectious disease hospitalisations, paediatric, patient registry, multinational study, Nordic countries