Skip to main content
Public Health Reports logoLink to Public Health Reports
. 1997 Nov-Dec;112(6):506–512.

Childhood asthma surveillance using computerized billing records: a pilot study.

R D Morris 1, E N Naumova 1, J Goldring 1, M Hersch 1, R L Munasinghe 1, H Anderson 1
PMCID: PMC1381930  PMID: 10822479

Abstract

OBJECTIVE: This paper describes a pilot project to develop and implement a low-cost system for ongoing surveillance of childhood asthma in Milwaukee County, Wisconsin. METHODS: The authors organized a planning workshop to solicit information and ideas for an asthma surveillance system, bringing together national experts with Milwaukee professionals and community representatives involved in the prevention and treatment of asthma. Based on recommendations from the workshop, a pilot surveillance project was implemented in Milwaukee County using records of emergency room visits and hospital admissions for asthma abstracted from the computerized billing records of the Children's Hospital of Wisconsin (CHW), retrospectively for 1993 and prospectively for 1994. Retrospective data were also sought from the other hospital emergency departments in Milwaukee County to evaluate the representativeness of the CHW data. Surveillance data were used to evaluate utilization of care by patient subgroups and to describe temporal patterns in emergency room visits. RESULTS: Of the emergency department visits for asthma in Milwaukee County in 1993, CHW accounted for 94% among infants less than 1 year of age, 89% among children ages 1 through 5 years, and only 59% among children between the ages of 6 and 18 years. In 1994, the 7% of asthmatic children with repeat hospital admissions accounted for 38% of all hospital admissions for asthma and the 20% with repeat emergency department visits accounted for 50% of all emergency visits. Emergency visits for asthma showed clear seasonality, with a peak in the fall and a smaller peak in the spring. CONCLUSIONS: Computerized medical billing data provide an opportunity for asthma surveillance at a relatively low cost. The data obtained are useful for tracking trends in exacerbations of asthma and the use of medical services for asthma care and should prove valuable in targeting interventions.

Full text

PDF
506

Selected References

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

  1. Agertoft L., Pedersen S. Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med. 1994 May;88(5):373–381. doi: 10.1016/0954-6111(94)90044-2. [DOI] [PubMed] [Google Scholar]
  2. Antó J. M., Sunyer J., Reed C. E., Sabrià J., Martínez F., Morell F., Codina R., Rodríguez-Roisín R., Rodrigo M. J., Roca J. Preventing asthma epidemics due to soybeans by dust-control measures. N Engl J Med. 1993 Dec 9;329(24):1760–1763. doi: 10.1056/NEJM199312093292402. [DOI] [PubMed] [Google Scholar]
  3. Bacalo A., Kivity S., Heno N., Greif Z., Greif J., Topilsky M. Blood transfusion and lung function in children with thalassemia major. Chest. 1992 Feb;101(2):362–365. doi: 10.1378/chest.101.2.362. [DOI] [PubMed] [Google Scholar]
  4. Brown C. M., Anderson H. A., Etzel R. A. Asthma. The states' challenge. Public Health Rep. 1997 May-Jun;112(3):198–205. [PMC free article] [PubMed] [Google Scholar]
  5. Djukanović R., Roche W. R., Wilson J. W., Beasley C. R., Twentyman O. P., Howarth R. H., Holgate S. T. Mucosal inflammation in asthma. Am Rev Respir Dis. 1990 Aug;142(2):434–457. doi: 10.1164/ajrccm/142.2.434. [DOI] [PubMed] [Google Scholar]
  6. 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]
  7. Goldring J., Hanrahan L., Anderson H. Asthma hospitalizations in Wisconsin: public health implications. Wis Med J. 1994 Feb;93(2):63–67. [PubMed] [Google Scholar]
  8. Haahtela T., Järvinen M., Kava T., Kiviranta K., Koskinen S., Lehtonen K., Nikander K., Persson T., Selroos O., Sovijärvi A. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med. 1994 Sep 15;331(11):700–705. doi: 10.1056/NEJM199409153311103. [DOI] [PubMed] [Google Scholar]
  9. Laitinen A., Laitinen L. A. Airway morphology: epithelium/basement membrane. Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 2):S14–S17. doi: 10.1164/ajrccm/150.5_Pt_2.S14. [DOI] [PubMed] [Google Scholar]
  10. Sexton K., Gong H., Jr, Bailar J. C., 3rd, Ford J. G., Gold D. R., Lambert W. E., Utell M. J. Air pollution health risks: do class and race matter? Toxicol Ind Health. 1993 Sep-Oct;9(5):843–878. doi: 10.1177/074823379300900509. [DOI] [PubMed] [Google Scholar]
  11. White M. C., Etzel R. A., Olson D. R., Goldstein I. F. Reexamination of epidemic asthma in New Orleans, Louisiana, in relation to the presence of soy at the harbor. Am J Epidemiol. 1997 Mar 1;145(5):432–438. doi: 10.1093/oxfordjournals.aje.a009125. [DOI] [PubMed] [Google Scholar]
  12. White M. C., Etzel R. A., Wilcox W. D., Lloyd C. Exacerbations of childhood asthma and ozone pollution in Atlanta. Environ Res. 1994 Apr;65(1):56–68. doi: 10.1006/enrs.1994.1021. [DOI] [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES