Skip to main content

Well-Child Care Attendance and Risk of Asthma Exacerbations.

Publication ,  Journal Article
Lang, JE; Tang, M; Zhao, C; Hurst, J; Wu, A; Goldstein, BA
Published in: Pediatrics
December 2020

BACKGROUND: Asthma remains a leading cause of hospitalization in US children. Well-child care (WCC) visits are routinely recommended, but how WCC adherence relates to asthma outcomes is poorly described. METHODS: We conducted a retrospective longitudinal cohort study using electronic health records among 5 to 17 year old children residing in Durham County with confirmed asthma and receiving primary care within a single health system, to compare the association between asthma exacerbations and previous WCC exposure. Exacerbations included any International Classification of Diseases, Ninth Revision, or International Classification of Diseases, 10th Revision, coded asthma exacerbation encounter with an accompanying systemic glucocorticoid prescription. Exacerbations were grouped by severity: ambulatory encounter only, urgent care, emergency department, hospital encounters <24 hours, and hospital admissions ≥24 hours. In the primary analysis, we assessed time to asthma exacerbation based on the presence or absence of a WCC visit in the preceding year using a time-varying covariate Cox model. RESULTS: A total of 5656 children met eligibility criteria and were included in the primary analysis. Patients with the highest WCC visit attendance tended to be younger, had a higher prevalence of private insurance, had greater asthma medication usage, and were less likely to be obese. The presence of a WCC visit in the previous 12 months was associated with a reduced risk of all-cause exacerbations (hazard ratio: 0.90; 95% confidence interval: 0.83-0.98) and severe exacerbations requiring hospital admission (hazard ratio: 0.53; 95% confidence interval: 0.39-0.71). CONCLUSIONS: WCC visits were associated with a lower risk of subsequent severe exacerbations, including asthma-related emergency department visits and hospitalizations. Poor WCC visit adherence predicts pediatric asthma morbidity, especially exacerbations requiring hospitalization.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

December 2020

Volume

146

Issue

6

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Morbidity
  • Male
  • Humans
  • Hospitalization
  • Female
  • Emergency Service, Hospital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lang, J. E., Tang, M., Zhao, C., Hurst, J., Wu, A., & Goldstein, B. A. (2020). Well-Child Care Attendance and Risk of Asthma Exacerbations. Pediatrics, 146(6). https://doi.org/10.1542/peds.2020-1023
Lang, Jason E., Monica Tang, Congwen Zhao, Jillian Hurst, Angie Wu, and Benjamin A. Goldstein. “Well-Child Care Attendance and Risk of Asthma Exacerbations.Pediatrics 146, no. 6 (December 2020). https://doi.org/10.1542/peds.2020-1023.
Lang JE, Tang M, Zhao C, Hurst J, Wu A, Goldstein BA. Well-Child Care Attendance and Risk of Asthma Exacerbations. Pediatrics. 2020 Dec;146(6).
Lang, Jason E., et al. “Well-Child Care Attendance and Risk of Asthma Exacerbations.Pediatrics, vol. 146, no. 6, Dec. 2020. Pubmed, doi:10.1542/peds.2020-1023.
Lang JE, Tang M, Zhao C, Hurst J, Wu A, Goldstein BA. Well-Child Care Attendance and Risk of Asthma Exacerbations. Pediatrics. 2020 Dec;146(6).

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

December 2020

Volume

146

Issue

6

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Morbidity
  • Male
  • Humans
  • Hospitalization
  • Female
  • Emergency Service, Hospital