Asthma is the second most common reason for childhood hospitalizations in the United States and is the leading cause of hospital admissions in children between 3 and 12 years of age. With costs of over $835 billion yearly, asthma hospital stays don't come cheap, and parents and doctors may wonder how to keep children with asthma out of hospital beds. Researchers from the Medical College of Wisconsin and Children's Hospital of Wisconsin in Milwaukee and Boston University School of Public Health studied parent and doctor perspectives on how to reduce childhood hospitalizations for asthma.
Over a 14-month period, researchers asked the parents of 230 children hospitalized for asthma to complete questionnaires about why their child was admitted to the hospital. The parents also noted whether they thought that anything could have been done to prevent their child's hospitalization. They also described their child's access to health care, whether the child had visited the doctor or health care provider before hospital admission, and whether they had any problems getting medications for their child. In addition, researchers also contacted the child's family doctor or pediatrician and the doctor at the hospital who treated the child to ask them whether they thought the child's hospitalization was preventable and why.
Only 26% of parents thought their child's admission was preventable compared with 38% of primary care doctors (PCPs) and 43% of hospital physicians. Here are some other findings:
- 83% of PCPs and 67% of hospital physicians - versus 44% of parents - cited parent/patient-related reasons for how hospitalizations could have prevented, such as taking and refilling medications as prescribed, better outpatient follow-up, and avoiding known asthma triggers.
- 27% of parents and 26% of hospital physicians - but only 11% of PCPs - said that PCPs could have provided better education or better care that could have prevented hospitalizations.
Doctors identified several other reasons why hospital admissions occurred:
- parents delayed or failed to get medical care for their child
- parents didn't educate themselves about their child's asthma
- parents failed to contact the PCP soon enough during an asthma flare-up
- parents didn't monitor the child's peak flow
- teens didn't take enough responsibility for their asthma care
What This Means to You: Many doctors and parents agree that asthma hospitalizations are often preventable, even if they don't agree on the reasons how they could be prevented. If your child has asthma, work with your child's doctor to develop an asthma management plan, which can help your child identify and control asthma triggers, anticipate and prevent asthma flare-ups, take medications as prescribed, and control flares when they occur. When you're developing the asthma plan, you might also discuss what you need from your child's doctor - whether it's more information on medications or more education about asthma in general - so that you can work together to help your child stay out of the hospital.
Source: Glenn Flores, MD; Milagros Abreu, MD; Sandra Tomany-Korman, MS; John Meurer, MD, MBA; Pediatrics, October 2005.
Reviewed by: Steven Dowshen, MD
Date reviewed: October 2005
