Background: Acute respiratory infections (ARI) are an important cause of childhood morbidity globally with socio-economically deprived children at a higher risk.
Aim: Using population-based administrative data in Western Australia, England and Scotland, we compared socio-economic disparities for hospitalisations for ARI in young children.
Methods: Separate retrospective cohort studies using linked population-based birth, death and hospitalisation data were conducted in each jurisdiction; data were available on births in Western Australia and Scotland, 2000-2012 and in England, 2003-2012. ARI hospitalisations in infants (<12 months old) and young children (1-4 years) were identified through a selection of ICD-10 diagnosis codes. We calculated admission rates per 1000 child-years by ARI diagnosis and socio-economic deprivation using jurisdiction specific socio-economic deprivation scores.
Results: The overall infant ARI admission rate was 44.3/1000 child-years in Western Australia, 40.7/1000 in Scotland and 40.1/1000 in England. Equivalent rates in children aged 1-4 years were 9.0, 7.6 and 7.6. Bronchiolitis was the most common diagnosis for infant admissions in all jurisdictions. Compared with infants from the least deprived socio-economic areas, those from the most deprived areas had a higher risk of ARI admissions, more so in Western Australia (incidence rate ratio 3.9 [95% confidence interval 3.5, 4.2]) than in England (1.9 [1.7, 2.1]) or Scotland (1.3 [1.1, 1.4]).
Conclusions: Admissions for ARI were higher in Western Australia and displayed greater socio-economic disparities than England and Scotland. Prevention programs focusing on disadvantaged populations in all three countries are likely to translate into real improvements in the burden of ARI in children.