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Risk factors for emergency department use among children with asthma using primary care in a managed care environment

Jennifer Elston Lafata1, Hugo Xi, George Divine

  • 1Center for Health Services Research, Henry Ford Health System, Detroit, Mich 48202, USA. JLAFATA1@hfhs.org

Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association
|July 24, 2002
PubMed

Insights

Children with asthma who previously visited the emergency department (ED) are at higher risk for future ED use. Encouraging regular primary care and allergist visits can help reduce asthma-related ED visits.

Area of Science:

  • Pediatric Pulmonology
  • Health Services Research
  • Epidemiology

Background:

  • Emergency department (ED) utilization for asthma exacerbations is a significant concern in pediatric healthcare.
  • Identifying risk factors for ED use is crucial for developing targeted interventions within managed care settings.

Purpose of the Study:

  • To pinpoint risk factors associated with emergency department (ED) visits for childhood asthma.
  • To inform strategies for reducing ED utilization among pediatric asthma patients receiving primary care.

Main Methods:

  • A retrospective cohort study analyzed data from 411 children aged 5-14 with asthma enrolled in a health maintenance organization (HMO).
  • Logistic regression models with generalized estimating equation approaches were used to identify predictors of asthma-related ED visits over two-year periods.
  • Automated data sources were utilized for patient identification and follow-up.

Main Results:

  • Twenty-three percent of children experienced at least one asthma-related ED visit.
  • Prior ED use for asthma was a strong predictor of future ED visits (OR = 8.26).
  • Increased age and frequency of primary care visits for asthma were associated with decreased ED use, while seeing an allergist showed a trend towards reduced ED visits.

Conclusions:

  • Children with a history of asthma-related ED visits represent a high-risk group for future utilization.
  • Promoting consistent primary care engagement and specialist (allergist) consultation may effectively decrease ED use in pediatric asthma patients.
  • Interventions should focus on proactive management and care coordination to prevent asthma exacerbations requiring emergency care.
Abstract

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