162655 Asthma hospital discharges associated with pneumonia and influenza in Washington, DC 1997-2004

Sunday, November 4, 2007

Gebreyesus Kidane, PhD, MPH , Center for Policy, Planning and Epidemiology, District of Columbia Department of Health, Washington, DC
Kerda DeHaan, MS , Center for Policy, Planning and Epidemiology, District of Columbia Department of Health, Washington, DC
MaryFrances Kornak, MPH , DC Control Asthma Now, Deptartment of Health, Washington, DC
George Siaway, MSEH , Center for Policy, Planning and Epidemiology, D.C. Department of Health, Washington, DC
Garret Lum, MPH , Center for Policy, Planning and Epidemiology, District of Columbia Department of Health, Washington, DC
John O. Davies-Cole, PhD, MPH , Center for Policy, Planning and Epidemiology, District of Columbia Department of Health, Washington, DC
The District of Columbia has one of the nation's highest asthma rates. Although this condition can occur in all facets of the population, recent studies indicate that most children with asthma are in low-income and minority populations. One effective preventive measure of hospitalization is the influenza vaccine. It is estimated that fewer than 10% of children and 40% of adults with asthma receive this vaccine yearly.

Objective To assess asthma hospitalizations and its implications with associated respiratory diseases.

Methodology Hospital discharges from 1997-2004 were analyzed using SPSS. All diagnoses of asthma were used, regardless of discharge position. Data were analyzed by age, gender, race, and insurance status. Logistic regression has been used to assess the relative risk of being diagnosed with a co-morbid respiratory disease. Spatial analysis was done to determine directional distribution of hospital discharges.

Results The highest proportion of asthma diagnoses, out of total hospital discharges, was observed in the 1-4 and 5-14 age-specific groups with 24.4% and 18.7%, respectively. There was a three-fold higher risk of having a diagnosis for influenza in those hospitalized and diagnosed with asthma (p<.05). When mapped by zip code, dramatic disparities are revealed. Those areas of low socio-economic status are the most likely to be discharged due to an asthma hospitalization.

Conclusion Vaccination for influenza in those under 15 years of age with known asthma could potentially reduce the number and severity of hospitalizations for asthma. Administering the influenza vaccine could result in substantial savings in related health care costs.

Learning Objectives:
•To utilize hospital discharge data using ICD-9 codes with primary and secondary diagnoses. •To gain an understanding in applying spatial analysis to hospital discharge data. •To demonstrate how hospitalizations for asthma can potentially be mitigated by influenza vaccine.

Keywords: Asthma, Immunizations

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.