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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
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    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
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