Children's emergency department use for asthma, 2001-2010
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Published on: November 4, 2010
1Department of Emergency Medicine, University of California, San Francisco, San Francisco, Calif.
Insights
The rate of emergency department (ED) visits for pediatric asthma remained stable, yet disparities persist. Younger children, minorities, and those with Medicaid/CHIP were more likely to have preventable asthma ED visits.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Health Services Research
Background:
- Emergency departments (EDs) are crucial for critically ill children.
- A significant number of pediatric ED visits are for potentially preventable conditions like asthma.
- Understanding trends and disparities in pediatric asthma ED visits is vital for public health.
Purpose of the Study:
- To analyze trends in pediatric emergency department (ED) visits for asthma from 2001 to 2010.
- To identify demographic, clinical, and structural factors associated with potentially preventable asthma ED visits in children.
Main Methods:
- Retrospective analysis of pediatric ED visits (ages 2-17) from 2001-2010 using the National Hospital Ambulatory Medical Care Survey.
- Classification of visits as potentially preventable using ICD-9-CM codes and the Agency for Healthcare Research and Quality's pediatric asthma quality indicator.
- Trend analysis using weighted linear regression and factor analysis using multivariate logistic regression.
Main Results:
- The overall rate of pediatric ED visits for asthma saw a 13.3% increase between 2001 and 2010 (8.2 to 9.3 per 1000 children).
- Potentially preventable asthma ED visits were more common in younger children, males, racial/ethnic minorities, and those insured by Medicaid/Children's Health Insurance Program (CHIP).
- Visits occurring overnight (11 pm - 7 am) were also more likely to be for preventable asthma crises.
Conclusions:
- The overall rate of potentially preventable pediatric asthma ED visits did not significantly change over the study decade.
- Persistent racial and insurance-based disparities in preventable asthma-related ED visits highlight ongoing public health challenges.
- Targeted interventions are needed to address socioeconomic and demographic factors contributing to preventable pediatric asthma ED visits.
Objectives:
Although the emergency department (ED) provides essential care for severely ill or injured children, past research has shown that children often visit the ED for potentially preventable illnesses, including asthma. We sought to determine how children's rate of ED visits for asthma has changed over the last decade and to analyze what factors are associated with a child's potentially preventable ED visit for asthma.
Methods:
We retrospectively analyzed ED visits by children aged 2 to 17 from 2001 to 2010 using data from the National Hospital Ambulatory Medical Care Survey. Visits were classified as potentially preventable asthma visits by mapping ICD-9-CM diagnosis codes to the Agency for Healthcare Research and Quality's asthma pediatric quality indicator. We examined trends in the annual rate of ED visits for asthma per 1000 children using a weighted linear regression model. Finally, we used multivariate logistic regression to determine what demographic, clinical, and structural factors were associated with a child's ED visit being for a potentially preventable asthma crisis.
Results:
The rate of children's ED visits for asthma increased 13.3% between 2001 and 2010, from 8.2 to 9.3 visits per 1000 children (P = .26). ED visits by children who were younger, male, racial or ethnic minorities, insured with Medicaid/Children's Health Insurance Program, and visiting between 11 pm and 7 am were more likely to be for potentially preventable asthma crises.
Conclusions:
Although the overall rate of potentially preventable ED visits for asthma did not significantly change over the last decade, racial, insurance-based, and other demographic disparities in the likelihood of a preventable asthma-related ED visit persist.
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