Related Experiment Video
Updated: Mar 26, 2026
Author Spotlight: Evaluating the Therapeutic Efficacy of Moving Cupping Along Meridians for Acute Exacerbation of COPD
Published on: September 27, 2024
Effects of continuity of care on emergency department utilization in children with asthma
Shu-Tzu Huang, Shiao-Chi Wu1, Yen-Ni Hung
1Institute of Health and Welfare Policy, School of Medicine, National Yang Ming University, No. 155, Sec 2, Linong S, Taipei, 112 Taiwan, Republic of China.
Insights
High continuity of ambulatory asthma care significantly lowers emergency department visits for children with asthma. Ensuring consistent follow-up care is crucial for reducing healthcare utilization in pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Public Health Policy
Background:
- Asthma is a prevalent chronic respiratory condition in children, often leading to emergency department (ED) visits.
- Continuity of care in ambulatory settings is hypothesized to improve health outcomes and reduce healthcare resource utilization.
- Understanding the impact of care continuity on pediatric asthma ED visits is essential for optimizing healthcare delivery in Taiwan.
Purpose of the Study:
- To investigate the association between continuity of ambulatory asthma care and asthma-specific ED utilization among children in Taiwan.
- To determine if higher continuity of care is linked to a reduction in emergency visits for pediatric asthma patients.
Main Methods:
- A retrospective cohort study utilizing Taiwan's National Health Insurance Dataset (2006-2009).
- Inclusion of new asthma patients aged 0-17 years diagnosed in 2007, with a two-year observation period.
- Calculation of the Continuity of Care Index (COCI) for ambulatory asthma care in the first year and analysis of asthma-specific ED utilization in the second year using two-part hurdle regression.
Main Results:
- A cohort of 29,277 children with asthma was analyzed, with an average COCI of 0.68.
- Patients with medium and low continuity of care exhibited significantly higher asthma-related ED utilization (OR 1.21 and 1.38, respectively) compared to those with high COCI.
- No statistically significant correlation was found between continuity of care and the number of ED visits among patients who utilized ED services.
Conclusions:
- High continuity of ambulatory asthma care is associated with a reduced risk of asthma-specific ED utilization in newly diagnosed pediatric asthma patients in Taiwan.
- Healthcare providers and policymakers should emphasize and reinforce follow-up care and patient education, particularly for high-risk groups, to enhance care continuity.
- Strategies aimed at improving ambulatory care continuity can potentially decrease emergency healthcare burdens for pediatric asthma.
Objectives:
To examine whether continuity of ambulatory asthma care can lower asthma-specific emergency department (ED) utilization by children with asthma in Taiwan.
Study Design:
Retrospective cohort study based on claims data.
Methods:
We used the Taiwan National Health Insurance Dataset, 2006 to 2009. The study population was new asthma patients aged 0 to 17 years in 2007, and every case was observed for 2 years. We used the Continuity of Care Index (COCI) to calculate the continuity of ambulatory asthma care in the first year, and estimated the asthma-specific ED utilization in the second year. Two-part hurdle regression was used for statistical analysis.
Results:
The 29,277 patients in our study had an average COCI of 0.68 (± 0.31), and 42.3% of patients had an index of 1. More than 1 in 20 patients-1641 (5.61%)-had at least 1 asthma ED visit, and the mean number of visits per user was 1.46 (± 0.99). After controlling for covariates, the groups with medium and low continuity of ambulatory asthma care had 21% (odds ratio [OR], 1.21; 95% CI, 1.06-1.39) and 38% (OR, 1.38; 95% CI, 1.21-1.58) higher asthma-related ED utilization, respectively, than the group with high COCI. However, among users, the number of ED visits was not statistically correlated to the continuity of ambulatory asthma care.
Conclusions:
High continuity of ambulatory asthma care can decrease asthma-specific ED utilization risk in children with newly diagnosed asthma in Taiwan. We suggest that providers and the government reinforce the use of follow-up care and education for high-risk groups to improve the continuity of ambulatory asthma care.
Related Concept Videos
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Asthma-IV: Nursing Management
First, in...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:29Asthma-I: Introduction
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...