Child asthma care systems: Serious gaps in education and insurance

Asthma is the most common chronic childhood illness in the U.S., with an estimated 6.5 million children affected by this chronic disease. The burden of pediatric asthma continues to be significant for children, families and communities. Utilization of Emergency Departments (ED) and hospitalizations continue to be the markers of effectiveness of programs and services for this disease. A study was recently conducted to examine parents' perceptions of access to basic care and ED use for asthma management. A sample of 50 parents and guardians of children with asthma, who were admitted to the ED at a major children's hospital in the Southeastern U.S., were interviewed between March and August 2009. Children were 2-18 years of age. Each family underwent a semi-structured interview using a modified Barriers to Care Questionnaire. Although the majority of parents/guardians expressed having enough information about their child's asthma, only 7% of the participants were using an Asthma Management Plan and/or had a thorough understanding of triggers, preventive strategies and use of medications to manage asthma symptoms. Nearly half of parents/guardians also reported difficulties in obtaining asthma medications due to high cost and/or inadequate insurance coverage. While parents perceived they have access to care and sufficient knowledge of asthma management, it is clear that there are gaps in their knowledge and actions that appear to contribute to the use of the ED for management of asthma. These gaps in parent/guardian education, along with apparent cost/insurance deficiencies, suggest the need for significantly improved child asthma care systems.