BACKGROUND Monitoring the incidence of chronic health conditions (CHCs) in childhood in England, using administrative data to derive numerators and denominators, is challenged by unmeasured migration. We used open and closed birth cohort designs to estimate the cumulative incidence of CHCs to age 16 years. METHODS In closed cohorts, we identified all births in Hospital Episode Statistics (HES) from 2002/3 to 2011/12, followed to 2018/19 (maximum age 8 to 16 years), censoring on death, first non-England residence record or 16th birthday. Children must have linked to later HES records and/or the National Pupil Database, which provides information on all state school enrolments, to address unmeasured emigration. The cumulative incidence of CHCs was estimated to age 16 using diagnostic codes in HES inpatient records. We also explored temporal variation. Sensitivity analyses varied eligibility criteria. In open cohorts, we used HES data on all children from 2002/3 to 2018/19 and national statistics population denominators. RESULTS In open and closed approaches, the cumulative incidence of ever having a CHC recorded before age 16 among children born in 2003/4 was 25% (21% to 32% in closed cohort sensitivity analyses). There was little temporal variation. At least 28% of children with any CHC had more than one body system affected by age 16. Multimorbidity rates rose with later cohorts. CONCLUSIONS Approximately one-quarter of children are affected by CHCs, but estimates vary depending on how the denominator is defined. More accurate estimation of the incidence of CHCs requires a dynamic population estimate.

中文翻译：

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英格兰从出生到 16 岁的住院患者中记录的慢性健康状况的累积发生率。


背景 监测英格兰儿童期慢性健康状况 （CHC） 的发病率，使用行政数据得出分子和分母，受到未测量迁移的挑战。我们使用开放和封闭出生队列设计来估计 CHC 到 16 岁的累积发病率。方法 在封闭队列中，我们在医院事件统计 （HES） 中确定了从 2002 年 3 月到 2011 年 12 月的所有出生，然后到 2018/19 年 （最大年龄 8 至 16 岁），根据死亡、首次非英格兰居住记录或 16 岁生日截尾。儿童必须链接到后来的 HES 记录和/或国家学生数据库，该数据库提供有关所有公立学校入学的信息，以解决未衡量的移民问题。使用 HES 住院记录中的诊断代码估计 CHC 的累积发病率至 16 岁。我们还探讨了时间变化。敏感性分析不同的合格标准。在开放队列中，我们使用了 2002/3 年至 2018/19 年所有儿童的 HES 数据和国家统计人口分母。结果 在开放和封闭方法中，2003/4 年出生的儿童在 16 岁之前记录过 CHC 的累积发生率为 25%（在封闭队列敏感性分析中为 21% 至 32%）。时间变化很小。至少 28% 的 CHC 儿童在 16 岁时有多个身体系统受到影响。多病共存率随着队列的增加而上升。结论 大约四分之一的儿童受到 CHCs 的影响，但估计值因分母的定义而异。更准确地估计 CHC 的发病率需要动态的人群估计。