Rehospitalization of children with asthma

Research output: Contribution to journalArticle

Abstract

Background: Although some children with asthma experience multiple admissions, asthma is considered a preventable cause of hospitalization. Objective: To assess whether components of medical histories, ambulatory care prior to hospitalization, or ambulatory care after discharge are associated with repeated hospitalizations for children admitted with asthma: Design: Nested case-control study of a cohort o f children hospitalized for asthma, comparing those who were rehospitalized within 1 year with those not rehospitalized. Setting: Urban pediatric primary care clinic. Participants and Methods: Subjects were 119 children, aged 0 to 14 years, who had an inpatient admission with a diagnosis of asthma between July 1, 1993, and June 30, 1995 (index hospitalization). Data sources included medical charts, computerized patient records, and administrative data. Use of health care services was compared among children who were rehospitalized within I year of the index admission and those who were not. Main Outcome Measure: Repeated hospitalizations. Results: The proportions of children who received general pediatric, allergy, or pulmonary care in the year prior to the index hospitalization were 86%, 7%, and 8%, respectively. By report, half of all children did not receive prescribed therapies, more than half were exposed to cigarette smoke at home, and one fourth were not up-to-date with immunizations at the time of admission. Thirty-five of the 119 children hospitalized with asthma were subsequently readmitted with asthma within 1 year of the index hospitalization. Children readmitted did not differ from those with a single admission in terms of the above characteristics. However, significantly more children subsequently readmitted had a pulmonary consultation during the index admission (23% vs 4%; P = .001) or in the year following discharge (37% vs 12%; P = .002). In addition, children readmitted were more likely to have other chronic conditions (69% vs 49%; P = .048). Conclusion: Among low-income urban children, readmission for asthma is not associated with receipt of prescribed therapies or pediatric care.

Original languageEnglish (US)
Pages (from-to)727-730
Number of pages4
JournalArchives of Pediatrics and Adolescent Medicine
Volume153
Issue number7
StatePublished - Jul 1999

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Asthma
Hospitalization
Hospitalized Child
Pediatrics
Ambulatory Care
Computerized Medical Records Systems
Lung
Information Storage and Retrieval
Smoke
Tobacco Products
Health Services
Case-Control Studies
Inpatients
Immunization
Primary Health Care
Hypersensitivity
Referral and Consultation
Outcome Assessment (Health Care)
Delivery of Health Care
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Rehospitalization of children with asthma. / Minkovitz, Cynthia S; Andrews, John S.; Serwint, Janet Rose.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 153, No. 7, 07.1999, p. 727-730.

Research output: Contribution to journalArticle

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abstract = "Background: Although some children with asthma experience multiple admissions, asthma is considered a preventable cause of hospitalization. Objective: To assess whether components of medical histories, ambulatory care prior to hospitalization, or ambulatory care after discharge are associated with repeated hospitalizations for children admitted with asthma: Design: Nested case-control study of a cohort o f children hospitalized for asthma, comparing those who were rehospitalized within 1 year with those not rehospitalized. Setting: Urban pediatric primary care clinic. Participants and Methods: Subjects were 119 children, aged 0 to 14 years, who had an inpatient admission with a diagnosis of asthma between July 1, 1993, and June 30, 1995 (index hospitalization). Data sources included medical charts, computerized patient records, and administrative data. Use of health care services was compared among children who were rehospitalized within I year of the index admission and those who were not. Main Outcome Measure: Repeated hospitalizations. Results: The proportions of children who received general pediatric, allergy, or pulmonary care in the year prior to the index hospitalization were 86{\%}, 7{\%}, and 8{\%}, respectively. By report, half of all children did not receive prescribed therapies, more than half were exposed to cigarette smoke at home, and one fourth were not up-to-date with immunizations at the time of admission. Thirty-five of the 119 children hospitalized with asthma were subsequently readmitted with asthma within 1 year of the index hospitalization. Children readmitted did not differ from those with a single admission in terms of the above characteristics. However, significantly more children subsequently readmitted had a pulmonary consultation during the index admission (23{\%} vs 4{\%}; P = .001) or in the year following discharge (37{\%} vs 12{\%}; P = .002). In addition, children readmitted were more likely to have other chronic conditions (69{\%} vs 49{\%}; P = .048). Conclusion: Among low-income urban children, readmission for asthma is not associated with receipt of prescribed therapies or pediatric care.",
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