Background Preschool-aged children have among the highest burden of acute wheeze. We investigated differences in healthcare use, treatment and outcomes for recurrent wheeze/asthma in preschoolers from different ethno-socioeconomic backgrounds. Methods Retrospective cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics in England. We reported number of acute presentations and hospitalisations stratified by index of multiple deprivation (IMD) and ethnicity; and factors associated with treatment non-escalation, and hospitalisation rates using multivariable logistic and Poisson regression models. Results 194 291 preschool children were included. In children not trialled on asthma preventer medications, children from the most deprived IMD quintile (adjusted OR 1.67; 95% CI 1.53 to 1.83) and South Asian (1.77; 1.64 to 1.91) children were more likely to have high reliever usage and where specialist referral had not occurred, the odds of referral being indicated was higher in the most deprived quintile (1.39; 1.28 to 1.52) and South Asian (1.86; 1.72 to 2.01) children compared with the least deprived quintile and white children, respectively. Hospitalisation rates for wheeze/asthma were significantly higher in children from the most deprived quintile (adjusted IRR 1.20; 95% CI 1.13 to 1.27) compared with the least, and in South Asian (1.57; 1.44 to 1.70) and black (1.32; 1.22 to 1.42) compared with white children. Conclusions We identified inequalities in wheeze/asthma treatment and morbidity in preschool children from more deprived, and non-white backgrounds. A multifaceted approach to tackle health inequality at both the national and local levels, which includes a more integrated and standardised approach to treatment, is needed to improve health outcomes in children with preschool wheeze/asthma. Data may be obtained from a third party and are not publicly available. Datasets used in this analysis were obtained via a Clinical Practice Research Datalink (CPRD) institutional licence. Requests for data should be made directly to the CPRD via their online application portal (). Code lists used to identify the cohort is available at .

中文翻译：

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英格兰学龄前儿童复发性喘息社会经济剥夺、种族与健康结局之间的关联：一项回顾性队列研究


背景 学龄前儿童的急性喘息负担最重。我们调查了来自不同种族社会经济背景的学龄前儿童在医疗保健使用、治疗和复发性喘息/哮喘结果方面的差异。方法 使用来自与英格兰医院事件统计相关的临床实践研究数据链的数据进行回顾性队列研究。我们报告了按多重剥夺指数 （IMD） 和种族分层的急性表现和住院人数;以及与治疗非升级和住院率相关的因素，使用多变量 logistic 和 Poisson 回归模型。结果 共纳入 194 291 例学龄前儿童。在未试验使用哮喘预防药物的儿童中，来自最贫困的 IMD 五分之一（校正 OR 1.67;95% CI 1.53 至 1.83）和南亚（1.77;1.64 至 1.91）儿童更有可能使用高缓解药物，在没有发生专科医生转诊的情况下，最贫困的五分之一（1.39;1.28 至 1.52）和南亚（1.86;1.72 至 2.01）儿童的转诊几率高于最贫困的五分之一儿童分别是贫困的五分之一儿童和白人儿童。与最贫困的五分之一儿童相比，来自最贫困的五分之一儿童（校正后的 IRR 1.20;95% CI 1.13 至 1.27）的喘息/哮喘住院率显著高于最低群体，与白人儿童相比，南亚儿童（1.57;1.44 至 1.70）和黑人（1.32;1.22 至 1.42）的住院率更高。结论 我们确定了来自更贫困和非白人背景的学龄前儿童喘息/哮喘治疗和发病率的不平等。 需要一种多方面的方法来解决国家和地方层面的健康不平等问题，其中包括一种更加综合和标准化的治疗方法，以改善学龄前喘息/哮喘儿童的健康结果。数据可能从第三方获得，并且不会公开。本分析中使用的数据集是通过临床实践研究数据链 （CPRD） 机构许可证获得的。数据请求应通过 CPRD 的在线申请门户 （） 直接向 CPRD 提出。用于标识同类群组的代码列表可在 上找到。