title: Emergency department visits attributable to asthma in North Carolina, 2008.
abstract: BACKGROUND
  Asthma is a prevalent, morbid, and costly chronic condition that may result in preventable exacerbations requiring emergency department (ED) care. In North Carolina we have limited information about the frequency and characteristics of asthma-related ED visits.
  
  
  METHODS
  We estimated statewide population-based asthma-related ED visit rates in North Carolina, both overall and by age, sex, geography, insurance, and season.
  
  
  RESULTS
  There were 86,700 asthma-related ED visits in North Carolina in 2008, representing 2.1% of all ED visits in the state. Substantial geographic variation existed, with rates ranging from 1.3 visits per 1,000 population in Ashe County to 21.0 visits per 1,000 population in Pasquotank County. Rates by age, sex, and month were consistent with the findings of other studies. Of asthma ED visits, 4.8% were preceded by another asthma visit to the same ED within 14 days. The proportion of patients who made at least 1 additional asthma visit to the same ED within 365 days was 23.5%; 11.6% of asthma ED patients met at least 1 criterion for being at high risk of hospitalization or death.
  
  
  CONCLUSIONS
  We lacked data on ED visits for asthma outside North Carolina, information about the accuracy of asthma diagnosis in the ED, patient identifiers that would allow linking across EDs, data on race or ethnicity, and data on urgent care utilization.
  
  
  CONCLUSIONS
  We have characterized the burden of asthma in EDs across North Carolina, by county and among key subpopulations. These data can be used to target and evaluate local and statewide asthma-control policy efforts.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC 27599-7411, USA. klich@unc.edu
authors.forename: Kristen Hassmiller
authors.initials: KH
authors.lastname: Lich
authors.forename: Debbie
authors.initials: D
authors.lastname: Travers
authors.forename: Wayne
authors.initials: W
authors.lastname: Psek
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Karin
authors.initials: K
authors.lastname: Yeatts
authors.forename: Winston
authors.initials: W
authors.lastname: Liao
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lippmann
authors.forename: Levi
authors.initials: L
authors.lastname: Njord
authors.forename: Anna
authors.initials: A
authors.lastname: Waller
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012621:Seasons; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult