Disparities in Asthma Hospitalizations among Children Seen in the Emergency Department

Kruse, Lakota; Deshpande, Sandy; Vezina, Melissa

doi:10.1080/02770900701750163

Cited by 22 publications

(14 citation statements)

References 21 publications

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“…30–32 Moreover, asthma is associated with a 50% increased risk of hospital admission among pediatric ED patients, with Black children having the greatest rates of asthma-related ED use and hospitalization. 33,34 Prior research suggests that repeat asthma-related use of EDs may indicate challenges accessing or engaging in effective care, and lack of access to optimal treatment. 35 …”

Section: Discussionmentioning

confidence: 99%

Pediatric Use of Emergency Medical Services: The Role of Chronic Illnesses and Behavioral Health Problems

Knowlton

Weir

Fields

et al. 2016

Prehospital Emergency Care

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Objective The increasing use of prehospital emergency medical services (EMS) and its contribution to rising emergency department use and healthcare costs point to the need for better understanding factors associated with EMS use to inform preventive interventions. Understanding patient factors associated with pediatric use of EMS will inform pediatric-specific intervention. We examined pediatric patient demographic and health factors associated with one-time and repeat use of EMS. Methods We reviewed data from Baltimore City Fire Department EMS patient records over a 23-month period (2008–10) for patients under 21 years of age (n=24,760). Repeat use was defined as involvement in more than one EMS incident during the observation period. Analyses compared demographics of EMS users to the city population and demographics and health problems of repeat and one-time EMS users. Health comparisons were conducted at the patient and incident levels of analysis. Results Repeat users (n=1,931) accounted for 9.0% of pediatric users and 20.8% of pediatric incidents, and were over-represented among the 18–20 year age group and among females. While trauma accounted for approximately one-quarter of incidents, repeat versus one-time users had a lower proportion of trauma-related incidents (7.2% versus 26.7%) and higher proportion of medical-related incidents (92.6% versus 71.4%), including higher proportions of incidents related to asthma, seizures, and obstetric/gynecologic issues. In patient-level analysis, based on provider or patient reports, greater proportions of repeat compared to one-time users had asthma, behavioral health problems (mental, conduct and substance use problems), seizures and diabetes. Conclusions Chronic somatic conditions and behavioral health problems appear to contribute to a large proportion of the repeat pediatric use of this EMS system. Interventions may be needed to engage repeat users in primary care and behavioral health services, to train EMS providers on the recognition and management of behavioral health emergencies, and to improve family care and self-management of pediatric asthma and other chronic conditions.

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Section: Discussionmentioning

confidence: 99%

Pediatric Use of Emergency Medical Services: The Role of Chronic Illnesses and Behavioral Health Problems

Knowlton

Weir

Fields

et al. 2016

Prehospital Emergency Care

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“…Conversely, there is evidence that physicians do not always prescribe controller medications, particularly for minority children, even when there are significant symptoms of asthma. 31,32 These patterns may be influenced by policies specific to each health care system or insurance plan, as noted above.…”

Section: Discussionmentioning

confidence: 99%

Beliefs and barriers to medication use in parents of Latino children with asthma

McQuaid

Vásquez

Canino

et al. 2009

Pediatric Pulmonology

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Summary Objective Disparities in asthma outcomes exist between Latino and non-Latino white (NLW) children. We examined rates of medication use, medication beliefs, and perceived barriers to obtaining medication in US and island Puerto Rican parents of children with asthma Hypotheses Island PR parents would report the lowest rates of controller medication use, followed by RI Latino and RI NLW parents; Latino parents would report more medication concerns than NLW parents; and Island PR parents would report the most barriers to medication use. Study Design Five hundred thirty families of children with persistent asthma participated, including 231 Island PR, 111 RI NLW, and 188 RI Latino. Parents completed survey measures. Results Group differences were found on reported use of ICS (X2 = 50.96, P <0.001), any controller medication (X2 = 56.49, P <0.001), and oral steroids (X2 = 10.87, P <0.01). Island PR parents reported a greater frequency of barriers to medication use than the other two groups (X2 = 61.13, P <0.001). Latino parents in both sites expressed more medication concerns than NLW parents (F = 20.18, P <0.001). Medication necessity was associated with ICS use in all three groups (all P’s <0.01). Medication concerns were positively associated with ICS use in PR only (OR = 1.64, P <0.05). Conclusions Differences in medication beliefs and the ability to obtain medications may explain the reported disparity in controller medication use. Further studies are needed to evaluate these obstacles to medication use.

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“…Rural areas have a particularly high frequency of asthma attacks, that cause absences from school and work [9,10], presentation to emergency departments [11] and admittance to hospitals [12]. A difference between the rural and urban regions was also detected in asthma-related mortality in a pediatric population [13,14].…”

Section: Introductionmentioning

confidence: 96%

The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

et al. 2013

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Disparities in Asthma Hospitalizations among Children Seen in the Emergency Department

Cited by 22 publications

References 21 publications

Pediatric Use of Emergency Medical Services: The Role of Chronic Illnesses and Behavioral Health Problems

Pediatric Use of Emergency Medical Services: The Role of Chronic Illnesses and Behavioral Health Problems

Beliefs and barriers to medication use in parents of Latino children with asthma

The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

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