Pediatric asthma hospitalizations and associated factors in California

Asthma is the most common chronic respiratory condition of childhood worldwide. In 2021, about 25% of Californians had at some point been diagnosed with asthma. Between 2008 and 2010, the age-adjusted rate of pediatric asthma deaths was 1.9 in California but 5 in San Bernardino. In this study, we compare rates of pediatric asthma hospitalizations across California counties and examine factors correlating to reduced asthma attacks.

We analyzed two datasets. The first dataset was from the California Health and Human Services Open Data Portal (CA ODP), "Rates of Preventable Hospitalizations (Age < 18) for Selected Medical Conditions by County." Selected counties included Los Angeles, San Bernardino, Kern, Fresno, Alameda, and Santa Clara. The second dataset was from the California Health Interview Survey, Public Use Files (CHIS PUFs), for Teens and Children for years 2018-2022.

Risk-adjusted rates showed a noticeable difference between pediatric asthma hospitalizations across California, with the highest rates being seen in Fresno County at 160.0 per 100,000. Reduced asthma attacks in the past year were significantly associated with having a written asthma action plan (p = 0.004) and receiving one from a healthcare provider (p < 0.001). Participants with a usual source of care other than the emergency room (ER) had fewer asthma attacks compared to those without (p = 0.028).

Pediatric asthma morbidity remains high throughout different California regions, with increased rates being seen in Fresno. Various factors including consistent healthcare provider access and written asthma action plans play a role in asthma prognosis.