The 130th Annual Meeting of APHA

Abstract #41423

Jonathan C. Wallace, MA, MPH¹, Lakota K. Kruse, MD, MPH², and Charles E. Denk, Ph D¹. (1) Maternal and Child Health Epidemiology, New Jersey Department of Health and Senior Services, P.O. Box 364, Trenton, NJ 08625-0364, 609-292-5656, jwallace@doh.state.nj.us, (2) Division of Family Health Services, New Jersey Department of Health and Senior Services, P O Box 364, Trenton, NJ 08625

Background: Asthma is the most frequent reason for preventable hospital admissions among children. Children in New Jersey, especially boys under five years of age, have disproportionately higher asthma hospitalization rates than adults. An asthma surveillance effort developed by the New Jersey Department of Health and Senior Services under funding by the Centers for Disease Control and Prevention analyzed hospitalization data to identify populations most at risk for severe asthma morbidity. Few surveillance reports differentiate between hospitalizations and unique patients. Objectives: Identify pediatric populations at higher risk for repeat hospitalizations and assess the impact of multiple hospitalizations on disparities.

Methods: Records from New Jersey Hospital Discharge Files (1993-1999) were linked via probabilistic matching software to identify patients with multiple asthma hospitalizations. Results: Within the linked file, 31.4% of the encounters were readmissions within the study period, 22.5% occurred within a year of prior admission, and 3.4% within 28 days. Non-Hispanic blacks had a 1.3 fold higher risk than non-Hispanic whites for readmission. Risk of readmission within 28 days was highest for 15-17 year olds and lowest for 5-9 year olds, a 1.6 fold range. However, disparities in overall admission rates by sex, age, and race/ethnicity are not substantially distorted by readmissions. The trend shows stability in readmission rates and points towards initial hospitalizations as a more direct measure of asthma morbidity. Implications: Patient-specific data provides more information than admission data alone and can augment admission rates as benchmarks in assessing asthma management programs.

Learning Objectives: Objectives

• Identify racial/ethnic disparities in asthma hospitalization rates.
• Develop a strategy for analyzing rates compensating for multiple repeat admissions.
• Characterize demographic rates of patients with multiple hospitalizations for asthma

Keywords: Asthma, Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.