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310062
High asthma self-efficacy is associated with less ambulatory care sensitive utilization and missed work in adults with asthma
Monday, November 17, 2014
: 3:30 PM - 3:45 PM
Ifna Ejebe, AB
,
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
Lauren E. Wisk, PhD
,
Department of Population Medicine, Harvard Medical School, Boston, MA
Elizabeth A. Jacobs, MD, MPP
,
Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
Ambulatory care sensitive emergency department (ED) utilization, hospitalizations, and reduced work productivity are indicators of poor asthma control. Asthma self-efficacy, the confidence an individual has to control and manage asthma, has been shown to be associated with disease management behavior and medication adherence. Despite this, little is known about how rates of high asthma self-efficacy are associated with rates of ambulatory care sensitive health care utilization and productivity at the population level. We examined data from adults with self-reported asthma (n = 7,874) in the 2009 and 2011-2012 of the California Health Interview Survey, a cross-sectional biennial population-based survey. Our outcomes of interest include asthma-related: ED visits, hospitalizations, and any days missed of work in the previous 12 months. Our explanatory variable of interest is high asthma self-efficacy, defined as reporting “very confident” in managing and controlling asthma. We used multivariable logistic regression to model the odds of ED and inpatient utilization, and missed work due to asthma, adjusting for sociodemographic characteristics, asthma severity, and access-related factors; the predicted probability of each event was calculated from these models. Compared to low self-efficacy, high self-efficacy was associated with lower rates of ED visits (6.7% vs 15.0%, p<0.01), hospitalizations (2.1% vs 4.4%, p<0.01), and missed work (8.7% vs 19.3%, p<0.01) after adjustment for potential confounders. This is equivalent to at least 123,470 fewer emergency department visits, 42,576 fewer hospitalizations, and 144,758 fewer days missed of work due to asthma over a two year period. Increasing the levels of asthma self-efficacy in adults with asthma has the potential to significantly reduce ambulatory care sensitive emergency department utilization and hospitalizations as well as work loss, leading to reduced direct and indirect healthcare costs.
Learning Areas:
Chronic disease management and prevention
Epidemiology
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Learning Objectives:
Describe the association of asthma self-efficacy with ambulatory care sensitivity health care utilization and work loss.
Keyword(s): Asthma, Self-Efficacy
Presenting author's disclosure statement:Qualified on the content I am responsible for because: Ifna Ejebe is currently an MD/PhD student at the Department of Population Health at the University of Wisconsin-Madison School of Medicine and Public Health. Her research interests include access to and impact of chronic disease self-management education and support for adults with chronic conditions.
Any relevant financial relationships? No
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.
