Rainbow research reveals young children with asthma visit emergency department most often

(Press-News.org) Contact information: Katelyn McCarthy
katelyn.mccarthy@uhhospitals.org
University Hospitals Case Medical Center
Rainbow research reveals young children with asthma visit emergency department most often Second study presented at the American Academy of Pediatrics National Conference reviews incidence of adverse drug events in hospitalized children CLEVELAND: New research from a University Hospitals Rainbow Babies & Children's Hospital (UH Rainbow) study found that children ages 1 to 3 years accounted for one-fifth of all emergency department (ED) visits caused by complications from asthma, representing the highest proportion of visits among asthma patients under age 21. In addition, 55 percent of all ED visits due to asthma occurred in boys, and fall months – September, October and November – had a relatively high proportion of visits compared to other times of the year. The research was presented at the American Academy of Pediatrics (AAP) National Conference in Orlando.

Asthma is the most common chronic childhood disease, affecting close to seven million children in the U.S. More than two-thirds of asthma-induced ED visits occurred among children residing in areas with annual household income levels below $50,000. The study also found the total asthma-related ED charges across the U.S. totaled $2.6 billion, averaging to about $1,300 per visit. Medicaid paid for half of all these visits, while private insurance plans paid for about 35 percent. The majority of children were treated and discharged routinely from the ED, while about one in 10 were admitted to the hospitals as patients.

"This study looked at more than 2.3 million ED visits among children with asthma, and we identified some interesting trends that give a baseline to find better ways to help children with asthma control this very treatable disease," said Aparna Roy, MD, MPH, lead author of the study and resident at UH Rainbow and Case Western Reserve University School of Medicine. "These findings reinforce the need to educate parents, especially those with children at higher risk, about how to manage the disease on a day-to-day basis to avoid costly emergency visits."

At AAP, Dr. Roy also presented an analysis of adverse drug events (ADE) among hospitalized children in the U.S. from 2003 to 2010. Results revealed that medication errors and ADEs in pediatric inpatient settings gradually increased between 2003 and 2010, although the cause for this increase requires further study. Overall, of the more than 62 million hospitalizations among children in the U.S. during this time frame, less than one percent experienced ADEs.

"While the overall incidence of adverse drug events among hospitalized children was low, nearly half a million children experienced ADEs and the steady upward trend of ADEs among this population is worrisome. We are planning additional research to evaluate whether better ADE reporting may play a role in this increase and if we can identify common causes so we can better reduce the number that occur," said Dr. Roy.

### About the Studies

H2022: Hospital Medicine Scientific Poster Presentations
Epidemiological Estimates and Outcomes Associated with Asthma Attacks in Children in United States
October 27, 8:00 AM-3:30 PM

Dr. Roy presented findings from an analysis of ED visits caused by asthma exacerbations in patients aged 21 years of age and under. The study used the 2009 Nationwide Emergency Department Sample of Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality to determine characteristics and outcomes among patients with asthma visiting ED's.

H2021: Critical Care Poster Walk Rounds and Break
Adverse Drug Events in Hospitalized Children: Estimates from the Nationwide Inpatient Sample 2003-2010
October 27, 9:30 AM-10:45 AM

Dr. Roy presented an analysis of children 21 years of age and younger in the U.S. who experienced an ADE while in the hospital. The study conducted a retrospective analysis of the Nationwide Inpatient Sample (NIS) for the years 2003 to 2010, identifying cases where a patient had an external cause of injury code. NIS is the largest all-payer hospital discharge database that is a part of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality.

About University Hospitals Rainbow Babies & Children's Hospital Located on the campus of University Hospitals Case Medical Center in Cleveland, Ohio, University Hospitals Rainbow Babies & Children's Hospital is a 244-bed, full-service children's hospital and academic medical center dedicated to the healthcare needs of children. A trusted leader in children's healthcare for more than 125 years, UH Rainbow Babies & Children's Hospital consistently ranks among the top children's hospitals in the nation. As the region's premier resource for pediatric referrals, UH Rainbow Babies & Children's Hospital's dedicated team of more than 1,300 pediatric specialists uses the most advanced treatments and latest innovations to deliver the complete range of pediatric specialty services for more than 700,000 patient encounters each year. Learn more at RainbowBabies.org.

Among the nation's leading academic medical centers, UH Case Medical Center is the primary affiliate of Case Western Reserve University School of Medicine, a nationally recognized leader in medical research and education. END