title: Impact of delay in asthma diagnosis on chest X-ray and antibiotic utilization by clinicians.
abstract: OBJECTIVE
  To evaluate the effect of the timeliness of asthma diagnosis on chest X-ray (CXR) and antibiotic utilization in children.
  
  
  METHODS
  This was a retrospective cohort study of 276 asthmatic children aged 5-12 years from Rochester, Minnesota. From the time when children met our predetermined asthma criteria, the frequency of CXR and antibiotic utilizations for respiratory illnesses were collected from medical records until age 18 years. Using a Poisson regression model, the frequency of CXR and antibiotic utilizations were compared in children with timely, delayed, or no clinician diagnosis of asthma.
  
  
  RESULTS
  Of the 276 asthmatic patients, 97 (35%) had a timely diagnosis, 122 (44%) had a delayed diagnosis, while 57 patients (21%) had no clinician diagnosis of asthma. There was no significant difference in CXR or antibiotic utilization for respiratory illness between these groups. In addition, this was true for the comparison between the timely diagnosed group and the delayed diagnosed group combining both the group with a delay in asthma diagnosis and the group who never had asthma diagnosis.
  
  
  CONCLUSIONS
  A delay in the diagnosis of asthma in children is common and overall it may not influence antibiotic and CXR utilization for respiratory symptoms by clinicians. However, its impact on access to asthma-related therapies and other healthcare utilizations could be possible and was not assessed in this study. Given the limitations of our study, a larger prospective study needs to be considered.
authors.affiliation: Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Lynch
authors.forename: Yilma
authors.initials: Y
authors.lastname: Fenta
authors.forename: Robert M
authors.initials: RM
authors.lastname: Jacobson
authors.forename: Xujian
authors.initials: X
authors.lastname: Li
authors.forename: Young J
authors.initials: YJ
authors.lastname: Juhn
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D057210:Delayed Diagnosis; D018450:Disease Progression; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008910:Minnesota; D016012:Poisson Distribution; D013902:Radiography, Thoracic / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents