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Variables Associated with Emergency Department Utilization by Pediatric Patients with Asthma in a Federally Qualified Health Center

  • Jesse ShechterEmail author
  • Angkana Roy
  • Sara Naureckas
  • Christopher Estabrook
  • Nivedita Mohanty
Original Paper
  • 21 Downloads

Abstract

To study variables associated with Emergency Department (ED) utilization among pediatric patients with asthma in a Federally Qualified Health Center (FQHC). We analyzed Electronic Health Record (EHR) data in a retrospective cohort study of patients with asthma between ages 2 and 18 who received primary care at a FQHC. The primary outcome studied was a visit to the ED at Ann and Robert Lurie’s Children’s Hospital (LCH) for an acute visit related to asthma. Univariate analyses and a multiple logistic regression were performed to study the effect of demographic and clinical variables on ED utilization. Of the 286 patients in the initial EHR query, 200 were included in the final analysis. The median age of subjects in the study cohort was 8.73 years. Patients in the cohort with ED visits averaged 1.32 ED visits in the 15-month period of analysis. The multivariable logistic regression model demonstrated the significant predictors of ED utilization were (1) younger age (OR 0.977, 0.968–0.984, P < 0.001), (2) proximity of patient residence to the hospital when compared with their primary care medical home (OR 0.907, 95% CI 0.828–0.992, P < 0.05), and (3) absence of an asthma action plan (OR 0.079, 95% CI, 0.016–0.283, P < 0.001). Younger age, closer relative proximity of the patient’s home to the hospital compared with the clinic, and absence of an asthma action plan were all identified as significant predictors of ED utilization. Sex, ethnicity, language, passive smoke exposure, and insurance status were not statistically significant predictors of ED utilization.

Keywords

Asthma Emergency Department Action plan 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Northwestern University Feinberg School of MedicineChicagoUSA
  2. 2.AllianceChicagoChicagoUSA

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