Abstract
This study assesses differences between users and non-users of unscheduled healthcare for persistent childhood asthma, with regard to select demographic and risk factors. The objectives are to provide important healthcare utilization information and a foundation for future research on self-management effectiveness (SME), informed by a recently developed “holistic framework” for measuring SME in childhood asthma. An 18-month retrospective chart review was conducted on 59 pediatric outpatients with persistent asthma—mild, moderate, or severe, to obtain data on various demographic and risk factors, and healthcare use for each child. The study examined five types of “unscheduled” healthcare use. Users had non-zero encounters (at least one) in any of the five types; non-users had zero encounters (not even one) in all five types. Differences between users and non-users were assessed using contingency table and logistic regression analysis. There were 25 users and 34 non-users of unscheduled healthcare. Each severity category contained users and non-users. The only statistically significant finding was that the mild persistent category had fewer users than severe persistent (p < 0.05). There were no significant differences between users and non-users for any other demographic or risk factor examined. After adjusting for asthma severity, there were no other significant differences between users and non-users of unscheduled healthcare. This is a crucial finding which suggests that something else is driving unscheduled healthcare use in these children, given there were users and non-users in each asthma severity category. These results provide impetus for future research on the role of other aspects of the "holistic framework" in explaining differences in uses of unscheduled healthcare in persistent childhood asthma.
Highlights
Asthma affects over 43 million Americans and is associated with enormous healthcare expenditures, including an estimated $56 billion/year in direct costs [1]
The objective of this study is to examine differences between users and non-users of unscheduled healthcare in persistent childhood asthma, in terms of select extrinsic factors informed by the “holistic framework,” variables obtained through records review, including individual demographic and risk factors
By gleaning a better understanding of the individual demographic and risk factors influencing unscheduled healthcare use in childhood asthma, we propose to provide a foundation for future research on self-management effectiveness (SME) of childhood asthma
Summary
Asthma affects over 43 million Americans and is associated with enormous healthcare expenditures, including an estimated $56 billion/year in direct costs [1]. According to the 2007 National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) evidence-based guidelines for asthma management and recent systematic meta-reviews of the literature, use of unscheduled and costly healthcare encounters, such as emergency visits, hospitalizations, or urgent care, can be prevented through effective self-management of asthma [2,3,4,5,6]. Res. Public Health 2020, 17, 2704; doi:10.3390/ijerph17082704 www.mdpi.com/journal/ijerph
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