Predictors of prior asthma specialist care among pediatric patients seen in the emergency department for asthma

Background: Asthma guidelines recommend specialist care for patients experiencing poor asthma outcomes during emergency department (ED) visits. The prevalence and predictors of asthma specialist care among an ED population seeking pediatric asthma care are unknown. Objective: To examine, in an ED po...

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Bibliographic Details
Published in:The Journal of asthma 2019-08, Vol.56 (8), p.816-822
Main Authors: Agnihotri, Neha T., Pade, Kathryn H., Vangala, Sitaram, Thompson, Lindsey R., Wang, Vincent J., Okelo, Sande O.
Format: Article
Language:English
Subjects:
Adolescent
Asthma - diagnosis
Asthma - epidemiology
Asthma - therapy
Child
Child, Preschool
control/management
Emergency Service, Hospital - statistics & numerical data
Female
Hospitals, Pediatric
Humans
Infant
Logistic Models
Male
Morbidity and mortality
Multivariate Analysis
Outcome Assessment, Health Care
pediatrics
Prognosis
Referral and Consultation - statistics & numerical data
Risk Assessment
Socioeconomic Factors
Specialization - statistics & numerical data
Treatment Outcome
United States
Urban Population
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Summary:Background: Asthma guidelines recommend specialist care for patients experiencing poor asthma outcomes during emergency department (ED) visits. The prevalence and predictors of asthma specialist care among an ED population seeking pediatric asthma care are unknown. Objective: To examine, in an ED population, factors associated with prior asthma specialist use based on parental reports of prior asthma morbidity and asthma care. Methods: Parents of children ages 0 to 17 years seeking ED asthma care were surveyed regarding socio-demographics, asthma morbidity, asthma management and current asthma specialist care status. We compared prior asthma care and morbidity between those currently cared for by an asthma specialist versus not. Multivariable logistic regression models to predict factors associated with asthma specialist use were adjusted for parent education and insurance type. Results: Of 150 children (62% boys, mean age 4.7 years, 69% Hispanic), 22% reported asthma specialist care, 75% did not see a specialist and for 3% specialist status was unknown. Care was worse for those not seeing a specialist, including under-use of controller medications (24% vs. 64%, p 
ISSN:0277-0903
1532-4303
DOI:10.1080/02770903.2018.1493600