Demographic and Risk Factor Differences between Children with "One-Time" and "Repeat" Visits to the Emergency Department for Asthma

Pavani Rangachari; Jie Chen; Nishtha Ahuja; Anjeli Patel; Renuka Mehta

doi:10.3390/ijerph18020486

Demographic and Risk Factor Differences between Children with "One-Time" and "Repeat" Visits to the Emergency Department for Asthma

Int J Environ Res Public Health. 2021 Jan 9;18(2):486. doi: 10.3390/ijerph18020486.

Authors

Pavani Rangachari¹, Jie Chen², Nishtha Ahuja³, Anjeli Patel³, Renuka Mehta⁴

Affiliations

¹ Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA.
² Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
³ Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
⁴ Division of Critical Care Medicine, Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.

Abstract

This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once ("one-time") and more than once ("repeat") over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0-17 years) who visited the ED for asthma in 2019-2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were "one-time" and 92 (37%) were "repeat" ED patients. Demographic and risk factor differences between "one-time" and "repeat" ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8-17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except age, none of the individual demographic or risk factors were statistically significant in predicting of "repeat" ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including age, race, gender, insurance, and asthma severity, among others) were statistically significant in predicting "repeat" ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving "repeat" ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.

Keywords: asthma management; emergency department; evidence-based practice guidelines; healthcare utilization; pediatric asthma; self-management effectiveness; “holistic framework”.

MeSH terms

Adolescent
Asthma* / epidemiology
Child
Demography
Emergency Service, Hospital*
Humans
Retrospective Studies
Risk Factors