Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1996 Oct;86(10):1410–1415. doi: 10.2105/ajph.86.10.1410

Factors associated with emergency department visits by children with asthma: implications for health education.

Y Wasilewski 1, N M Clark 1, D Evans 1, M J Levison 1, B Levin 1, R B Mellins 1
PMCID: PMC1380652  PMID: 8876510

Abstract

OBJECTIVES: This study investigated the relationship between psychosocial and behavioral factors and the frequency of emergency department visits for childhood asthma. METHODS: Data obtained from a survey of parents of 445 children who were being treated for asthma in the emergency room of a large urban hospital were examined. RESULTS: Factors associated with high emergency department use included the child's being of younger age, a greater number of days with symptoms of asthma, a higher number of asthma medicines prescribed, a prior hospitalization for asthma, a lower level of parental confidence in the efficacy of medicines, and a failure to use a criterion for deciding to seek emergency care. CONCLUSIONS: Younger children with asthma and children with previous hospitalization for asthma are at high risk for using emergency care. Families who use the emergency department frequently need to be further educated in the inflammatory nature of the disease, in the efficacy of proper use of medicine, in the need for ongoing care, and in criteria to distinguish those symptoms that can be handled at home from those requiring emergency care.

Full text

PDF
1410

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clark N. M., Feldman C. H., Evans D., Duzey O., Levison M. J., Wasilewski Y., Kaplan D., Rips J., Mellins R. B. Managing better: children, parents, and asthma. Patient Educ Couns. 1986 Mar;8(1):27–38. doi: 10.1016/0738-3991(86)90024-8. [DOI] [PubMed] [Google Scholar]
  2. Clark N. M., Feldman C. H., Evans D., Levison M. J., Wasilewski Y., Mellins R. B. The impact of health education on frequency and cost of health care use by low income children with asthma. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 1):108–115. doi: 10.1016/0091-6749(86)90122-3. [DOI] [PubMed] [Google Scholar]
  3. Eney R. D., Goldstein E. O. Compliance of chronic asthmatics with oral administration of theophylline as measured by serum and salivary levels. Pediatrics. 1976 Apr;57(4):513–517. [PubMed] [Google Scholar]
  4. Freudenberg N., Feldman C. H., Clark N. M., Millman E. J., Valle I., Wasilewski Y. The impact of bronchial asthma on school attendance and performance. J Sch Health. 1980 Nov;50(9):522–526. doi: 10.1111/j.1746-1561.1980.tb02079.x. [DOI] [PubMed] [Google Scholar]
  5. Gergen P. J., Weiss K. B. Changing patterns of asthma hospitalization among children: 1979 to 1987. JAMA. 1990 Oct 3;264(13):1688–1692. [PubMed] [Google Scholar]
  6. Hindi-Alexander M. C., Cropp G. J. Evaluation of a family asthma program. J Allergy Clin Immunol. 1984 Oct;74(4 Pt 1):505–510. doi: 10.1016/0091-6749(84)90386-5. [DOI] [PubMed] [Google Scholar]
  7. O'Brien S. R., Hein E. W., Sly R. M. Treatment of acute asthmatic attacks in a holding unit of a pediatric emergency room. Ann Allergy. 1980 Sep;45(3):159–162. [PubMed] [Google Scholar]
  8. Parcel G. S., Gilman S. C., Nader P. R., Bunce H. A comparison of absentee rates of elementary schoolchildren with asthma and nonasthmatic schoolmates. Pediatrics. 1979 Dec;64(6):878–881. [PubMed] [Google Scholar]
  9. Strecher V. J., DeVellis B. M., Becker M. H., Rosenstock I. M. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986 Spring;13(1):73–92. doi: 10.1177/109019818601300108. [DOI] [PubMed] [Google Scholar]
  10. Sublett J. L., Pollard S. J., Kadlec G. J., Karibo J. M. Non-compliance in asthmatic children: a study of theophylline levels in a pediatric emergency room population. Ann Allergy. 1979 Aug;43(2):95–97. [PubMed] [Google Scholar]
  11. Sullivan S. D., Weiss K. B. Assessing cost-effectiveness in asthma care: building an economic model to study the impact of alternative intervention strategies. Allergy. 1993;48(17 Suppl):146–163. doi: 10.1111/j.1398-9995.1993.tb04719.x. [DOI] [PubMed] [Google Scholar]
  12. Weiss K. B., Gergen P. J., Crain E. F. Inner-city asthma. The epidemiology of an emerging US public health concern. Chest. 1992 Jun;101(6 Suppl):362S–367S. doi: 10.1378/chest.101.6.362s. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES