IMPACT DC: Reconceptualizing the Role of the Emergency Department for Urban Children with Asthma

Quint, Deborah M.; Teach, Stephen J.

doi:10.1016/j.cpem.2009.03.003

Cited by 9 publications

(2 citation statements)

References 35 publications

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“…6 These epidemics disproportionately affect minority children with lower socioeconomic status, many of whom live in urban communities. 1,5,7 For example, the majority of children admitted for asthma reside in urban areas and mean hospital charges are highest for this group. 5 Children with asthma from urban environments exhibit increased obesity prevalence rates, and obesity has been associated with abnormal lung function, increased asthma symptoms and poor asthma control.…”

Section: Resultsmentioning

confidence: 99%

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Aragona

El-Magbri

Wang

et al. 2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVE:The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus. METHODS:A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (lean ,85%, overweight 85%-95%, obese $95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed. RESULTS:The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0-2.6). When stratified by age, overweight/obese preschool-age children (,5 years) were .2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0-5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups.

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Section: Resultsmentioning

confidence: 99%

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Aragona

El-Magbri

Wang

et al. 2016

Hospital Pediatrics

View full text Add to dashboard Cite

show abstract

“…While our intervention participation rates were low, they were comparable with other studies that target improving access to asthma care. (36;37) …”

Section: Discussionmentioning

confidence: 99%

Asthma in Head Start children: Effects of the Breathmobile program and family communication on asthma outcomes

Eakin¹,

Rańd²,

Bilderback³

et al. 2012

Journal of Allergy and Clinical Immunology

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Background Asthma morbidity and mortality rates are high among young inner-city children. Lack of routine primary care provider (PCP) visits, poor access to care, and poor patient-physician communication may be contributing factors. Objective This study evaluated the effects of providing Breathmobile services only, a Facilitated Asthma Communication Intervention (FACI) only, or both Breathmobile+FACI on asthma outcomes, relative to standard care. Methods Children with asthma (n=322, mean age=4 years, 53% male, 97% African American) were recruited from Head Start programs in Baltimore City and randomized into four groups. Outcome measures included symptom-free days, urgent care use (emergency department visits and hospitalizations) and medication use (courses of oral steroids and proportion on an asthma controller medication) as reported by caregivers at baseline, 6-, and 12-month assessments. Generalized Estimating Equations models were conducted to examine the differential treatment effects of Breathmobile and FACI compared to standard care. Results Children in the combined treatment group (Breathmobile+FACI) had an increase of 1.7 (6.6%) symptom-free days (SFD) that was not maintained at 12 months. In intent-to-treat analyses, the FACI-only group had an increase in the number of ED visits at 6 months, which was not present at 12 months or in the post hoc as-treated analyses. No significant differences were found between the intervention groups as compared to standard care on all other outcome measures. Conclusions Other than a slight improvement in SFD at 6 months in the Breatmobile+FACI group, the intervention components did not result in any significant improvements in asthma management or asthma morbidity.

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Access to care issues and the role of EDs in the wake of the Affordable Care Act

Janke¹,

Brody²,

Overbeek³

et al. 2015

The American Journal of Emergency Medicine

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IMPACT DC: Reconceptualizing the Role of the Emergency Department for Urban Children with Asthma

Cited by 9 publications

References 35 publications

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus

Asthma in Head Start children: Effects of the Breathmobile program and family communication on asthma outcomes

Access to care issues and the role of EDs in the wake of the Affordable Care Act

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