title: Inhaled Corticosteroid Claims and Outpatient Visits After Hospitalization for Asthma Among Commercially Insured Children.
abstract: To determine rates of inhaled corticosteroid (ICS) claims and outpatient follow-up after asthma hospitalization among commercially insured children.
  
  
  
  We conducted a retrospective cohort analysis of children hospitalized for asthma using 2013 national Truven MarketScan data. Covariates included age, sex, region, length of stay, and having an ICS claim within 35 days before hospitalization. Outcome variables were a claim for any ICS-containing medication and outpatient visit within 30 days after discharge. Multivariable analysis used logistic regression.
  
  
  
  A total of 5471 children aged 2 to 17 were included; 61% were boys, and mean age was 6.8 years. Forty-one percent had a claim for an ICS and 76% had an outpatient visit within 30 days after hospital discharge. In multivariable analysis, children who had an ICS claim within 35 days before the hospitalization were more likely to have an ICS claim within 30 days after discharge (relative risk [RR] 1.3, 95% confidence interval [CI] 1.2-1.5). The strongest predictor of an ICS claim within 30 days after discharge was attendance at an outpatient appointment (RR 1.4, 95% CI 1.3-1.6). Children aged 2 to 6 were more likely to attend an outpatient appointment (RR 1.1, 95% CI 1.1-1.2). Children with an ICS claim before admission were also more likely to attend an outpatient appointment (RR 1.1, 95% CI 1.004-1.1).
  
  
  
  In this national sample of commercially insured children with asthma, rates of ICS claims after hospitalization are low despite high rates of outpatient visits. Both inpatient and outpatient physicians must play a role in increasing ICS adherence in this high-risk population of children with asthma.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina College of Medicine, Medical University of South Carolina College of Medicine, Charleston, SC. Electronic address: andrewsan@musc.edu.
authors.forename: Annie Lintzenich
authors.initials: AL
authors.lastname: Andrews
authors.affiliation: Department of Pediatrics, Medical University of South Carolina College of Medicine, Medical University of South Carolina College of Medicine, Charleston, SC.
authors.forename: David G
authors.initials: DG
authors.lastname: Bundy
authors.affiliation: Department of Healthcare Leadership and Management, Medical University of South Carolina College of Health Professions, Charleston, SC.
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
authors.affiliation: Department of Pediatrics, Medical University of South Carolina College of Medicine, Medical University of South Carolina College of Medicine, Charleston, SC.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Teufel
authors.affiliation: Department of Healthcare Leadership and Management, Medical University of South Carolina College of Health Professions, Charleston, SC.
authors.forename: Jillian
authors.initials: J
authors.lastname: Harvey
authors.affiliation: Department of Healthcare Leadership and Management, Medical University of South Carolina College of Health Professions, Charleston, SC.
authors.forename: Annie N
authors.initials: AN
authors.lastname: Simpson
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000359:Aftercare / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones
keywords: asthma; controller medications; hospital follow-up; transitions