Lack of routine preventive care as a determinant for pediatric asthma

Objectives. The prevalence and incidence of asthma has been continually increasing with in the US. High rates of hospitalization, emergency room visits and infrequent prescribing of controller medications indicates the inadequacies of asthma management in the home as well as primary care programs. This study examines the impact of adequate asthma management and preventive care on asthma ER visits.

Methods. Data from the 2003 National Health Interview Survey was utilized. Children (N=653) less than 18 years, who have had an asthma episode in the past year were included. A composite variable was created to determine adequacy of care, using standards from the Global Initiative for Asthma (GINA) supported by the National Heart, Lung and Blood Institute.

Results. The prevalence of ER visit among children with asthma in the past we months was 22.7%. Approximately 24% of the children had inadequate asthma management and preventive care. The multiple logistic regression analysis showed that asthma management and preventive care were important determinants for asthma ER visits. Compared to children who had adequate care, children with inadequate asthma management and preventive care were two times more likely to visit the ER for asthma related problems [OR=2.06 (95%CI=1.257, 3.361)], with child's age, maternal education, and family income also statistically significant determinants.

Conclusions. Practices that support early interventions for asthma management and preventive care were associated with reduced risk of ER visits. Initiatives to support mandatory asthma management education and programming at primary care practices and in the home are essential in managing pediatric asthma.