Paediatric Eczema Hospital Admissions, and Topical Corticosteroid Dispensing Pre- and Post-Admission, in New Zealand From 2007 to 2019.

Abstract

Aim: To determine prevalence rates of paediatric hospital admissions for eczema/dermatitis in New Zealand (NZ), and assess demographics of these patients. Additionally, to evaluate dispensing of topical corticosteroids in the 12 months prior to and following hospital admission as a marker of healthcare access.

Methods: National retrospective observational study of all children aged up to 14 years admitted to hospital in NZ for eczema/dermatitis from 1 January 2007 to 31 December 2019. Analysis of dispensing records of topical corticosteroids for all children aged up to 15 years from 1 January 2006 to 31 December 2020. Evaluation of topical corticosteroid dispensing during the 12 months pre- and post-hospital admission, plus comparison to those children dispensed topical corticosteroids, but not admitted to hospital.

Results: The rate of paediatric hospital admission for eczema in NZ was 79.2/100 000 population/year. Hospital admission was significantly higher for Māori children (rate ratio [RR] 6.19, 95% confidence interval [CI] 5.60-6.86), Pacific children (RR 12.35, 95% CI 11.10-13.74), and those of low socioeconomic status (RR 3.89 95% CI 3.43-4.40). Almost one third of children aged < 1 year and just under one fifth of school-aged children were not dispensed topical corticosteroids prior to hospital admission. Most children (> 85%) were dispensed topical corticosteroids in the 12 months following admission.

Conclusions: Inequity in hospital admissions for eczema/dermatitis exists for Māori and Pacific children, and those living in areas of greatest deprivation. This research provides unique data on healthcare access for children admitted to hospital for eczema, and highlights areas in which interventions could be targeted.