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Impact of delay in asthma diagnosis on chest X-ray and antibiotic utilization by clinicians
Brian A Lynch1, Yilma Fenta, Robert M Jacobson
1Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Insights
A delayed asthma diagnosis in children is common but does not significantly affect chest X-ray (CXR) or antibiotic use for respiratory symptoms. Further research is needed on other healthcare impacts.
Area of Science:
- Pediatric Pulmonology
- Clinical Informatics
- Health Services Research
Background:
- Asthma diagnosis delays are frequent in pediatric populations.
- Understanding diagnostic timeliness is crucial for appropriate medical management.
Purpose of the Study:
- To assess the impact of timely asthma diagnosis on chest X-ray (CXR) and antibiotic utilization in children.
- To compare healthcare resource use based on the timing of asthma diagnosis.
Main Methods:
- Retrospective cohort study of 276 children aged 5-18 years with asthma.
- Analysis of medical records for CXR and antibiotic use following predetermined asthma criteria.
- Poisson regression model to compare utilization rates across timely, delayed, and undiagnosed groups.
Main Results:
- 35% of children received a timely asthma diagnosis, 44% a delayed diagnosis, and 21% had no clinician diagnosis.
- No significant differences in CXR or antibiotic utilization were observed between diagnostic timeliness groups.
- Combined analysis of delayed and undiagnosed groups also showed no significant difference in utilization.
Conclusions:
- Delayed asthma diagnosis in children is prevalent but may not influence CXR or antibiotic prescribing for respiratory symptoms.
- Potential impacts on asthma-related therapies and other healthcare access warrant further investigation.
- Larger, prospective studies are recommended to explore these associations.
Objective:
To evaluate the effect of the timeliness of asthma diagnosis on chest X-ray (CXR) and antibiotic utilization in children.
Patients And Methods:
This was a retrospective cohort study of 276 asthmatic children aged 5-12 years from Rochester, Minnesota. From the time when children met our predetermined asthma criteria, the frequency of CXR and antibiotic utilizations for respiratory illnesses were collected from medical records until age 18 years. Using a Poisson regression model, the frequency of CXR and antibiotic utilizations were compared in children with timely, delayed, or no clinician diagnosis of asthma.
Results:
Of the 276 asthmatic patients, 97 (35%) had a timely diagnosis, 122 (44%) had a delayed diagnosis, while 57 patients (21%) had no clinician diagnosis of asthma. There was no significant difference in CXR or antibiotic utilization for respiratory illness between these groups. In addition, this was true for the comparison between the timely diagnosed group and the delayed diagnosed group combining both the group with a delay in asthma diagnosis and the group who never had asthma diagnosis.
Conclusions:
A delay in the diagnosis of asthma in children is common and overall it may not influence antibiotic and CXR utilization for respiratory symptoms by clinicians. However, its impact on access to asthma-related therapies and other healthcare utilizations could be possible and was not assessed in this study. Given the limitations of our study, a larger prospective study needs to be considered.
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