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Routinely Sleeping Away from Home and the Association with Child Asthma Readmission

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Abstract

The increased prevalence of transitions between households may have implications for child asthma morbidity. We, therefore, sought to enumerate the prevalence of regularly spending nights sleeping away from home among children admitted to the hospital for asthma and to examine the relationship of nights away to asthma-related readmission. This was a population-based, prospective cohort of 774 children, aged 1–16 years, who were admitted with asthma or bronchodilator-responsive wheezing and enrolled in the Greater Cincinnati Asthma Risks Study. The study took place at Cincinnati Children’s Hospital Medical Center, an urban, academic children’s hospital in the Midwest. The primary exposure was regularly spending nights away from home. Selected covariates included caregiver marital status, shift work, child’s race, income, psychological distress, and running out of/not having medications on hand. The primary outcome was asthma-related readmission within 12 months. A total of 19 % were readmitted within 12 months. The 33 % of children that spent ≥1 night away from home per week were significantly more likely to be readmitted than those who spent no nights away (25 % vs. 16 %, p = 0.002). Spending nights away from home [adjusted relative risk (aRR) 1.5, 95 % confidence interval (CI) 1.2–2.0] and lower income (aRR 2.6, 95 % CI 1.1–6.4) were the strongest independent predictors of readmission after adjusting for child age, gender, and race, and caregiver marital status, shift work, risk of psychological distress, and running out of meds. Increased awareness of the multiple settings in which children with asthma live may help shape more comprehensive approaches to asthma care.

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Abbreviations

aRR:

Adjusted relative risk

CI:

Confidence interval

ER:

Emergency room

GCARS:

Greater Cincinnati Asthma Risk Study

CCHMC:

Cincinnati Children’s Hospital Medical Center

ICD-9CM:

International Classification of Diseases, 9th Edition, Clinical Modification

K6:

Kessler 6

DSM-IV:

Diagnostic and Statistical Manual Fourth Edition

SD:

Standard deviation

CAMP:

Childhood Asthma Management Program

NCICAS:

National Cooperative Inner-City Asthma Study

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Acknowledgments

We would also like to thank GCARS clinical research coordinators, Hadley Sauers, Emily Greenberg, Angela Howald, Elizabeth Monti, Stacey Rieck, and Heather Strong, for their support and dedication. This work was supported by National Institutes of Health (NIH) Grants RO1AI088116 (T.M., A.B., K.O., B.H., and R.K.) and K12 HD028827 (T.M.) and a Procter Scholar Award from the Cincinnati Children’s Research Foundation (A.B.). The project was also supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through Grant 8 UL1 TR000077-04. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or other funders.

Conflict of interest

The authors have no conflicts of interest or financial relationships to disclose.

Author information

Authors and Affiliations

  1. Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Terri Moncrief

  2. Divisions of General and Community Pediatrics and Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Andrew F. Beck

  3. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Kelly Olano & Bin Huang

  4. Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, ML 2011, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Robert S. Kahn

Authors
  1. Terri Moncrief
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  2. Andrew F. Beck
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  3. Kelly Olano
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  4. Bin Huang
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  5. Robert S. Kahn
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Correspondence to Robert S. Kahn.

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Moncrief, T., Beck, A.F., Olano, K. et al. Routinely Sleeping Away from Home and the Association with Child Asthma Readmission. J Community Health 39, 1209–1215 (2014). https://doi.org/10.1007/s10900-014-9880-4

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  • DOI: https://doi.org/10.1007/s10900-014-9880-4

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