Bronchiolitis severity and future healthcare utilization in healthy term infants

<bold>Introduction:</bold> Does bronchiolitis illness severity impact future healthcare utilization in young children? <bold>Aims:</bold> To determine differences in subsequent healthcare use in healthy, term children based on severity of initial episode. <bold>Methods:</bold> A retrospective cohort study compared healthcare utilization over 5 years after an index bronchiolitis hospital visit in healthy, term children <12 months of age discharged from hospitals in Calgary, Canada, Jan 1, 2010 – May 31, 2015. Patient information from electronic medical records. There were 3 exposure groups: emergency department (ED) only (mild illness); inpatient admission (moderate); pediatric intensive care unit (PICU) admission (severe) with bronchiolitis. Subsequent healthcare utilization was outpatient physician visits, ED visits and hospitalizations. <bold>Results:</bold> 2441 children had bronchiolitis. 1659 (68%) mild, 721 (29.5%) moderate, 61 (2.5%) severe (PICU admission). Those with severe illness had the highest rates of physician outpatient visits in the first year (median = 8) compared to those with moderate (median = 7, p = 0.02) and mild illness (median = 6, p <0.001). By year 5 there was no difference between the number of physician outpatient visits between groups (p = 0.71). Subsequent hospitalizations were higher in the moderate compared to the mild group during the first two years after diagnosis (first year, p < 0.001; second year, p = 0.018) but this difference resolved in the following years. Rates of ED visits did not differ across groups at any period. <bold>Relevance:</bold> Subsequent healthcare utilization in healthy, term children <12 months of age with mild, moderate or severe bronchiolitis is not meaningfully different by 5 years after initial illness.