title: Younger asthmatics are less likely to receive inhaled corticosteroids and asthma education after admission for exacerbation.
abstract: 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.
authors: Medical University of South Carolina, Charleston, SC, USA. lintzeni@musc.edu
authors: Annie
authors: A
authors: Lintzenich
authors: Ronald J
authors: RJ
authors: Teufel
authors: William T
authors: WT
authors: Basco
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents