Poster Presentation
Wednesday, 19 July 2006
9:30 AM - 10:00 AM
Wednesday, 19 July 2006
2:30 PM - 3:00 PM
Why are Rural School-Age Children with Asthma Having High Hospitalizations and Emergency Department Visits?
Sharon Horner, PhD, School of Nursing, The University of Texas at Austin, Austin, TX, USA
| Learning Objective #1: Discuss health care utilization among rural school-age children. |
| Learning Objective #2: Identify potential risk factors that may contribute to increased hospitalizations. |
Asthma is the most common chronic illness of childhood. In a tri-ethnic rural sample [Hispanic (49%), African American (24%), and White (27%)] of school-age children (n = 94) who have asthma, a large portion of the children had been hospitalized (18.4%) or seen in the emergency department (ED: 30.6%) for asthma in the preceding 12 months. The purpose of the present analysis was to examine those factors that may be contributing to this higher health care utilization. Significantly more boys (25.4%) than girls (7.7%) [p = .026]; more Hispanic (13%) than African American (5%) or White (1%) children [p = .034]; and more children who did not have bronchodilator medication [p = .047] were hospitalized for asthma. Hospitalized children had more severe asthma (p = .04) and more visits to the ED (p <.001) than those who were not hospitalized. There was a non-significant trend for children with lower socioeconomic status (p = .09) and no insurance [p = .10] to have more hospitalizations. Parent asthma management, reported barriers to care, and children’s absenteeism were not significantly different between children who were and were not hospitalized. However, absenteeism was much higher among boys than girls (6% v 3.2%) and higher among Hispanics (6.7%) than African Americans (3.6%) or Whites (3.8%). Implications from this analysis include the need for health care providers and school nurses to ensure that children have rescue medications, and assess risk factors such as ED visits and asthma severity. Increasing school absences may serve as a warning flag to alert school nurses to the need to monitor children closely for emerging problems with asthma.
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