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Master of Public Health
Epidemiology & Community Health
Objectives. The prevalence and incidence of asthma has been continually increasing with in the United States. High rates of hospitalization, emergency room visits (ER) and infrequent prescribing of controller medications indicates the lack or inadequacies of asthma management in the home as well as primary care programs. This study examines the impact of adequate asthma management and preventive care on asthma ER visits. Methods. Data from the 2003 National Health Interview Survey (NHIS) was utilized. Children (N=653) under the age of 18 years and who have had asthma episode in the past year were included for this analysis. A composite variable was created to determine adequacy of care at home and in the primary care setting using standards from the Global Initiative for Asthma (GINA) supported by the National Heart, Lung and Blood Institute.Results. The prevalence of ER visit among children who had asthma in the past 12 months was 22.7%. Approximately a quarter (24%) of the children had inadequate asthma management and preventive care. The multiple logistic regressions analysis showed that asthma management and preventive care were important determinants for asthma ER visits. Compared to children who had adequate care, children with inadequate asthma management and preventive care were two times more likely to visit the ER for asthma related problems [OR=2.06 (95%CI=1.257, 3.361)]. Child's age, maternal education, and family income were also statistically significant determinants for asthma related ER visits.Conclusions. Practices that support early interventions for asthma management and preventive care were associated with reduced risk of ER visits. Initiatives to support mandatory asthma management education and programming at primary care practices and as well as the home setting are essential in the management of pediatric asthma.
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