Effect of Disease Severity, Age of Child, and Clinic No-Shows on Unscheduled Healthcare Use for Childhood Asthma at an Academic Medical Center

Pavani Rangachari (), Imran Parvez, Audrey-Ann LaFontaine, Christopher Mejias, Fahim Thawer, Jie Chen, Niharika Pathak and Renuka Mehta
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Pavani Rangachari: Department of Population Health & Leadership, School of Health Sciences, University of New Haven, West Haven, CT 06516, USA
Imran Parvez: Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Audrey-Ann LaFontaine: Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Christopher Mejias: Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Fahim Thawer: Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Jie Chen: Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Niharika Pathak: Department of Population Health & Leadership, School of Health Sciences, University of New Haven, West Haven, CT 06516, USA
Renuka Mehta: Division of Critical Care Medicine, Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA

IJERPH, 2023, vol. 20, issue 2, 1-25

Abstract: This study examines the influence of various individual demographic and risk factors on the use of unscheduled healthcare (emergency and inpatient visits) among pediatric outpatients with asthma over three retrospective timeframes (12, 18, and 24 months) at an academic health center. Out of a total of 410 children who visited an academic medical center for asthma outpatient care between 2019 and 2020, 105 (26%) were users of unscheduled healthcare for childhood asthma over the prior 12 months, 131 (32%) over the prior 18 months, and 147 (36%) over the prior 24 months. multiple logistic regression (MLR) analysis of the effect of individual risk factors revealed that asthma severity, age of child, and clinic no-shows were statistically significant predictors of unscheduled healthcare use for childhood asthma. Children with higher levels of asthma severity were significantly more likely to use unscheduled healthcare (compared to children with lower levels of asthma severity) across all three timeframes. Likewise, children with three to four clinic no-shows were significantly more likely to use unscheduled healthcare compared to children with zero clinic no-shows in the short term (12 and 18 months). In contrast, older children were significantly less likely to use unscheduled healthcare use compared to younger children in the longer term (24 months). By virtue of its scope and design, this study provides a foundation for addressing a need identified in the literature for short- and long-term strategies for improving supported self-management and reducing unscheduled healthcare use for childhood asthma at the patient, provider, and organizational levels, e.g., (1) implementing telehealth services for asthma outpatient care to reduce clinic no-shows across all levels of asthma severity in the short term; (2) developing a provider–patient partnership to enable patient-centered asthma control among younger children with higher asthma severity in the long term; and (3) identifying hospital–community linkages to address social risk factors influencing clinic no-shows and unscheduled healthcare use among younger children with higher asthma severity in the long term.

Keywords: pediatric asthma; supported self-management of asthma; asthma severity; clinic no-shows; unscheduled healthcare use; social determinants of health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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