Younger asthmatics are less likely to receive inhaled corticosteroids and asthma education after admission for exacerbation.
BACKGROUND
Recommended care prior to discharge from an asthma hospitalization includes prescribing controller medications, providing asthma education, and scheduling a follow-up appointment.


OBJECTIVE
To identify factors associated with receipt of recommended preventive care among children hospitalized for asthma.


METHODS
Retrospective chart review of patients 2-18 years with primary diagnosis of asthma admitted to MUSC Children's Hospital in 2005. Gender, race, age (2-6 yrs v. 7-18 yrs), primary payer, and season of admission were recorded. Outcome variables were: prescription for inhaled corticosteroids (ICS), asthma education, and scheduling a follow-up appointment.


RESULTS
Of the 146 subjects analyzed, 59% were male, 69% non-white, 64% 2-6 years old, 73% Medicaid/other, and 66% were admitted between Oct-March. 73% were prescribed ICS, 71% got asthma education, and 66% had a follow-up appointment scheduled. Bivariate analyses showed that 2-6 year olds were less likely to get ICS (65% v. 88% p < .01) and asthma education (64% v. 84% p < .05). Multivariable analyses demonstrated that younger children were less likely to get ICS (OR= 0.27 95% CI 0.10 - 0.70), younger children were less likely to get asthma education (OR 0.29 95% CI 0.11- 0.74), and commercial payer patients were less likely to get follow-up appointments scheduled (OR 0.39 95% CI 0.18 -0.87) (all models, p < .05).


CONCLUSIONS
Among children hospitalized for asthma at our institution, younger patients are significantly less likely to receive inhaled steroids and asthma education. Targeting younger asthmatics may be a way to efficiently and effectively improve delivery of recommended preventive care in the hospital.
Lintzenich
Annie
A
Medical University of South Carolina, Charleston, SC, USA. lintzeni@musc.edu
Teufel
Ronald J
RJ
Basco
William T
WT
D000208:Acute Disease; D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents