Factors affecting ambulance utilization for asthma attack treatment: understanding where to target interventions

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Asthma attacks can be severe and life-threatening, sometimes necessitating emergency medical services (EMS) ambulance treatment.
• A significant portion of EMS-requiring asthma attacks may be preventable through enhanced education and healthcare access.

Purpose of the Study:

• To pinpoint urban areas with high EMS ambulance utilization for asthma.
• To identify demographic, socioeconomic, and temporal factors associated with these high-utilization areas.
• To inform targeted interventions for asthma emergency prevention and cost reduction.

Main Methods:

• A cross-sectional study analyzed 12,155 EMS ambulance-treated asthma cases in Houston, TX (2004-2011).
• Geospatial mapping identified high-utilization areas, with census tract data analyzed using logistic regression.
• Case-level demographics and attack times within high-rate areas were assessed via logistic regression.

Main Results:

• High-rate areas exhibited over six times the per capita EMS ambulance utilization for asthma compared to the rest of the city.
• Increased risk for high-rate area location was associated with lower income (<$10,000), Black ethnicity, female gender, and lower educational attainment.
• Within high-rate areas, asthma attacks were more likely to occur after regular doctor's office hours for men, Black individuals, and older/younger adults compared to children.

Conclusions:

• Interventions should be concentrated in identified high-rate areas and target at-risk demographic groups.
• Improving access to care outside of standard doctor's office hours is crucial in these locations.
• These targeted preventive measures are expected to decrease both ambulance use and emergency room visits.