title: Predictors of health care utilization of children with asthma in the community.
abstract: The aim of this study was to assess the pattern of use of health care services among children with asthma symptoms within the community, and assess groups at increased risk of emergency department (ED) visits or hospital admissions (HA). Using International Study of Asthma and Allergies in Childhood phase II protocol, information about asthma management and utilization of health care services was collected by parental questionnaire in a community-based random sample of 5-7- and 9-11-year-old children (n = 11,094) in Dresden and Munich. Only 11.2% of children with current wheeze did not utilize any health care facility or consultation for their asthma symptoms in the 12 months prior to survey, while 86.2%, 12.3%, and 3.6% had at least one asthma related physician's consultation, ED visits, or HA, respectively. Predictors of ED visits and HA among current wheezers were: younger age, male gender, speech-limiting wheeze, level of exposure to environmental tobacco smoke. In addition, children of low socioeconomic status were more likely to have ED visits because of their asthma. Childhood asthma is a major public health problem in Germany leading to substantial morbidity and utilization of health care services. Exposure to tobacco smoke comes out as the major modifiable risk factor related to asthma morbidity in children.
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
authors.forename: Wasim
authors.initials: W
authors.lastname: Maziak
authors.forename: Erika
authors.initials: E
authors.lastname: von Mutius
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
authors.forename: Thomas
authors.initials: T
authors.lastname: Hirsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Leupold
authors.forename: Peter
authors.initials: P
authors.lastname: Rzehak
authors.forename: Thomas
authors.initials: T
authors.lastname: Behrens
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Weiland
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution