A detailed description of the epidemiology of anaphylaxis worldwide using the latest data could help us better understand and compare the overall disease burden caused by anaphylaxis in different regions. By only reporting anaphylaxis among patients with a previous diagnosis of food allergy, patients who presented with anaphylaxis as their first food reaction might have been missed. Another systematic review in 2015 by Umasunthar et al 12 reported the risk of food-induced anaphylaxis in patients with food allergy, but not in a general population and not including other non-food triggers of anaphylaxis. Emerging studies from Asian regions also show a rising anaphylaxis incidence in South Korea 9 and Hong Kong 10 using national insurance claims data and hospital admission databases, respectively.Ī previous systematic review in 2013 by Panesar et al 11 summarized the epidemiology of anaphylaxis in Europe, but there has been no systematic review of anaphylaxis outside of Europe, and several additional studies published since late 2012 were not included in this review. 2 An increase in hospital presentation rates for anaphylaxis has been reported in Western countries such as Canada, 3 Finland, Sweden, 4 Australia, 5 the United Kingdom 6, 7 and the United States 8 using data from hospital administrative and national healthcare databases. 1 In 2015, Tejedor-Alonso reported an increase in both the number and quality of studies on the epidemiology of anaphylaxis over the past 10 years.
To accurately compare anaphylaxis incidence between countries and investigate the time trends, further studies using a standardized definition across different countries are required. Studies in developing countries are underrepresented. The reported incidence of anaphylaxis in children varied widely. Increasing total or food-induced anaphylaxis incidence over time was reported by 19 studies. Gender and ethnicity were demographic risk factors associated with anaphylaxis in children.
The definition of anaphylaxis from NIAID/FAAN was the most commonly used. The incidence of anaphylaxis in children worldwide varied widely, ranging from 1 to 761 per 100 000 person-years for total anaphylaxis and 1 to 77 per 100 000 person-years for food-induced anaphylaxis. Of these, 5 reported cumulative incidence, 39 reported incidence rate and 17 reported prevalence data. ResultsĪ final total of 59 articles were included. Studies in adults only or those that did not report data in children separately were excluded. Data extraction and risk of bias assessment were completed by the same two reviewers. Papers were screened by two independent reviewers following selection and exclusion criteria. The search strategy was designed in Medline (ovid) and modified for Embase (ovid) and PubMed. Results were reported following PRISMA guidelines. We conducted a systematic review, using a protocol registered and published with the international prospective register of systematic reviews (PROSPERO). The premium structure of an HMO reduces healthcare costs for families and, at the same time, benefits network providers by supplying them with more patients.Despite an increasing number of publications from individual countries and regions, there is still no systematic review of the global epidemiology of anaphylaxis in the general paediatric population. HMOs are some of the most popular managed care plans that employers provide to their employees. Why Does the Health Maintenance Organization (HMO) Matter?Ĭompanies often offer healthcare benefits to employees via HMOs. Subscribers may access services outside the network with the HMO's approval but may need to pay for part of the services. In return for a monthly fee, or premium, subscribers are granted access to providers inside the network at no additional cost.
The HMO agrees to pay these parties specific levels of compensation for a range of services they provide to its subscribers.
How Does the Health Maintenance Organization (HMO) Work?Īn HMO develops its network by contracting primary care physicians (for example, internists and family doctors), specialists (for example, cardiologists and ophthalmologists), and clinical facilities (for example, hospitals and specialty clinics).
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