IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i2p1508-d1035440.html
   My bibliography  Save this article

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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Pavani Rangachari & Imran Parvez & Audrey-Ann LaFontaine & Christopher Mejias & Fahim Thawer & Jie Chen & Niharika Pathak & Renuka Mehta, 2023. "Effect of Disease Severity, Age of Child, and Clinic No-Shows on Unscheduled Healthcare Use for Childhood Asthma at an Academic Medical Center," IJERPH, MDPI, vol. 20(2), pages 1-25, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1508-:d:1035440
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/2/1508/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/2/1508/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Krieger, J. & Higgins, D.L., 2002. "Housing and health: Time again for public health action," American Journal of Public Health, American Public Health Association, vol. 92(5), pages 758-768.
    2. Pavani Rangachari & Kathleen R. May & Lara M. Stepleman & Martha S. Tingen & Stephen Looney & Yan Liang & Nicole Rockich-Winston & R. Karl Rethemeyer, 2019. "Measurement of Key Constructs in a Holistic Framework for Assessing Self-Management Effectiveness of Pediatric Asthma," IJERPH, MDPI, vol. 16(17), pages 1-25, August.
    3. Marie-Josée Fleury & André Ngamini Ngui & Jean-Marie Bamvita & Guy Grenier & Jean Caron, 2014. "Predictors of Healthcare Service Utilization for Mental Health Reasons," IJERPH, MDPI, vol. 11(10), pages 1-28, October.
    4. Pavani Rangachari & Jie Chen & Nishtha Ahuja & Anjeli Patel & Renuka Mehta, 2021. "Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma," IJERPH, MDPI, vol. 18(2), pages 1-16, January.
    5. Pavani Rangachari & Dixie D. Griffin & Santu Ghosh & Kathleen R. May, 2020. "Demographic and Risk-Factor Differences between Users and Non-Users of Unscheduled Healthcare among Pediatric Outpatients with Persistent Asthma," IJERPH, MDPI, vol. 17(8), pages 1-12, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pavani Rangachari & Jie Chen & Nishtha Ahuja & Anjeli Patel & Renuka Mehta, 2021. "Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma," IJERPH, MDPI, vol. 18(2), pages 1-16, January.
    2. Kaylee Ramage & Meaghan Bell & Lisa Zaretsky & Laura Lee & Katrina Milaney, 2021. "Is the Right to Housing Being Realized in Canada? Learning from the Experiences of Tenants in Affordable Housing Units in a Large Canadian City," Societies, MDPI, vol. 11(2), pages 1-9, June.
    3. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    4. Carolina Navarro & Luis Ayala & José Labeaga, 2010. "Housing deprivation and health status: evidence from Spain," Empirical Economics, Springer, vol. 38(3), pages 555-582, June.
    5. Sima Alizadeh & Catherine E. Bridge & Bruce H. Judd & Valsamma Eapen, 2023. "Home Indoor Environmental Quality and Attention Deficit Hyperactivity Disorder," Sustainability, MDPI, vol. 15(4), pages 1-25, February.
    6. Milovanska-Farrington, Stefani, 2020. "Parents labor supply and childhood obesity: Evidence from Scotland," Economics & Human Biology, Elsevier, vol. 38(C).
    7. Dragan Gjorgjev & Mirjana Dimovska & George Morris & John Howie & Mirjana Borota Popovska & Marija Topuzovska Latkovikj, 2019. "How Good Is our Place—Implementation of the Place Standard Tool in North Macedonia," IJERPH, MDPI, vol. 17(1), pages 1-16, December.
    8. Philipp Ager & James J Feigenbaum & Casper W Hansen & Hui Ren Tan, 2024. "How the Other Half Died: Immigration and Mortality in U.S. Cities," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(1), pages 1-44.
    9. Judith Schröder & Susanne Moebus & Julita Skodra, 2022. "Selected Research Issues of Urban Public Health," IJERPH, MDPI, vol. 19(9), pages 1-28, May.
    10. Juan Pablo Díaz-Sánchez & Moisés Obaco & Javier Romaní, 2022. "Measuring Overcrowding in Households with Children: Official vs. Actual Thresholds in the Ecuadorian Case," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 15(2), pages 383-398, April.
    11. Min Zhou & Wei Guo, 2023. "Self-rated Health and Objective Health Status Among Rural-to-Urban Migrants in China: A Healthy Housing Perspective," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(1), pages 1-24, February.
    12. Sungwoo Lim & Pui Ying Chan & Sarah Walters & Gretchen Culp & Mary Huynh & L Hannah Gould, 2017. "Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-12, December.
    13. Völker, Sebastian & Kistemann, Thomas, 2013. "Reprint of: “I'm always entirely happy when I'm here!” Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany," Social Science & Medicine, Elsevier, vol. 91(C), pages 141-152.
    14. Stefan Angel & Benjamin Bittschi, 2019. "Housing and Health," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 65(3), pages 495-513, September.
    15. Quinonez, Pablo, 2022. "Social spending and income inequality in Latin America. A panel data approach," MPRA Paper 113538, University Library of Munich, Germany.
    16. Yang Xiao & Siyu Miao & Chinmoy Sarkar & Huizhi Geng & Yi Lu, 2018. "Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach," IJERPH, MDPI, vol. 15(2), pages 1-14, January.
    17. Badland, Hannah & Whitzman, Carolyn & Lowe, Melanie & Davern, Melanie & Aye, Lu & Butterworth, Iain & Hes, Dominique & Giles-Corti, Billie, 2014. "Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health," Social Science & Medicine, Elsevier, vol. 111(C), pages 64-73.
    18. Emma J. Kuhn & G. Stewart Walker & Harriet Whiley & Jackie Wright & Kirstin E. Ross, 2019. "Household Contamination with Methamphetamine: Knowledge and Uncertainties," IJERPH, MDPI, vol. 16(23), pages 1-15, November.
    19. repec:pri:crcwel:wp10-05-ff is not listed on IDEAS
    20. Diana Margot Rosenthal & Antoinette Schoenthaler & Michelle Heys & Marcella Ucci & Andrew Hayward & Ashlee Teakle & Monica Lakhanpaul & Celine Lewis, 2023. "How Does Living in Temporary Accommodation and the COVID-19 Pandemic Impact under 5s’ Healthcare Access and Health Outcomes? A Qualitative Study of Key Professionals in a Socially and Ethnically Diver," IJERPH, MDPI, vol. 20(2), pages 1-22, January.
    21. Nipuni Nilakshini Wimalasena & Alice Chang-Richards & Kevin I-Kai Wang & Kim N. Dirks, 2021. "Housing Risk Factors Associated with Respiratory Disease: A Systematic Review," IJERPH, MDPI, vol. 18(6), pages 1-24, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1508-:d:1035440. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.