Risk Factors Associated With Hospital Readmission in Pediatric Asthma
Section snippets
Design
The design of this study primarily followed the guidelines and framework published by the Center for Reviews and Dissemination (2009) for integrative reviews. The primary purpose of this review is to explore the association between pediatric asthma readmission and various risk factors including demographic, environmental, psychosocial and clinical factors. All risk factors discussed in the review represent these five classes.
Search Criteria
The inclusion criteria for target studies were: (a) stated purpose was primarily to examine readmission for pediatric asthma; (b) the target population was children aged 0–18; (c) published in English. Exclusion criteria were: (a) case reports, meta-analyses, or systemic review articles that did not adopt a research design; (b) abstracts, dissertations, manuscripts, or conference proceedings that were not published in peer reviewed journals; (3) theoretical, expert opinion, editorial, or any
Publication Years and Recruited Sample
Twelve out of 29 (41%) of the reviewed articles were published in the past five years (2009–2014). Fifteen of 29 (51.7%) reviewed papers were conducted in USA, and 5 (17%) were from Canada. There were also a portion of studies conducted from France, Nordic Countries, Netherlands, Turkey, Australia, and New Zealand, as well as other non-western countries including Thailand, Saudi Arabia, and Brazil.
The developmental stage of children in selected studies included all pediatric age group from
Demographic Risk Factors
The contradictory results from different studies indicate that age younger than 5 years and adolescents are two important age groups at risk for higher readmission after index discharge. Eight studies (Chen, Dales, et al., 2003, Delmas et al., 2011, Farber, 1998, Kocevar et al., 2004, Lasmar et al., 2006, Li et al., 2012, Mitchell et al., 1994, To et al., 1996, Wever-Hess et al., 2001) found that higher rates of asthma readmission occur in younger compared to older children. However, most
Limitations1
The inclusion and exclusion criteria adopted for this systematic review may pose some limitations to our findings. First, the choice of terms defining risk factor and readmission may have excluded some relevant studies. Secondly, all reviewed articles have no time limitations and includes studies from 1994 to 2014. During this time frame there has been some changes in the beliefs and emphasis in clinical practice related to the environmental impact on asthma diagnosis and treatment. Over the
Conclusions
This review includes a large number of studies that have examined risk factors associated with hospital readmission for pediatric asthma using various research designs. There have been several risk factors associated with increased hospital readmission in pediatric asthma population that have repeatedly emerged in these studies under the categories of demographic, environmental, psychosocial and clinical factors linked with asthma. Although demographic and clinical risk factors have been widely
Acknowledgments
No extramural funding.
No previous presentations.
No commercial financial support.
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Revealing the racial and spatial disparity in pediatric asthma: A Kansas City case study
2022, Social Science and MedicineCitation Excerpt :The risk profile clusters can also be integrated with the EHR as indicators of patient context, giving providers valuable insight into the types of exposures or place-based vulnerabilities that might affect a child's health outcomes (Angier et al., 2018). The distribution of the 2012 asthma encounter sample validates findings of an inequity in pediatric asthma health outcomes for Black and low-income children compared with their peers and is consistent with reported variation in the presentation and severity of asthma symptoms by sex and age (Capo-Ramos et al., 2014; Chung et al., 2015; Jones, 2020; Jones et al., 2019). At first glance, the distribution of controlled encounters might indicate that the over-representation of socially disadvantaged children in the CMH EHR is, at least in part, a consequence of the service area and in-network patient population; that minority and low-income children are more likely to show up in the sample regardless of asthma severity or prevalence in the general population.
Risk Factors for Pediatric Asthma Readmissions: A Systematic Review
2021, Journal of PediatricsCitation Excerpt :The association of older age (>12 years old) and early readmissions was similarly consistent. This finding has been reported before, but the causes have not been fully described.12 Qualitative interviews of key stakeholders (ie, parents, primary care providers, and/or inpatient clinicians) may shed light on this and other risk factors for readmission.
Bilevel Positive Airway Pressure ventilation efficiently improves respiratory distress in initial hours treating children with severe asthma exacerbation
2020, Journal of the Formosan Medical AssociationCitation Excerpt :Of note, a majority of the patients enrolled had history of readmission for asthma attack, and six of them had readmissions at PICU. All of PICU readmissions were female patients, causing and overwhelming gender disproportion in our study, while sex is not an identified risk factor for more severe attack.23–25 Magnesium sulfate was administered in 6 (24%) of the cases in BiPAP group as rescue treatment, resulting in statistical difference between groups.
Validation of Asthma Control Assessment Among Urban Adolescents Using the Asthma Control and Communication Instrument
2019, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :In addition, those studies frequently underrepresent individuals of urban settings, racial/ethnic minority backgrounds, and/or low socioeconomic status. These populations are important to study because they are less likely to receive the preventive asthma care recommended by NIH guidelines, they experience higher rates of acute health care use for asthma,5-7 and they are underrepresented in clinical research.8 There are also other experiences (eg, discrimination and stress) that directly and/or indirectly negatively affect asthma care and outcomes in these populations.9-11
Risk Factors for Return to the Emergency Department for Asthma: A Population-Based Study
2018, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Previous studies have also identified a number of factors associated with ED return for asthma after an initial asthma visit in the adult population.3-10,12-14 More severe disease,3,6,15-19 multiple comorbidities including mental illness,14,17 previous hospitalizations or ED visits for asthma,15,16,20 lower socioeconomic status (SES),3,8,18 being uninsured,14 not being white or being Aboriginal,2,14,18 and not having a written asthma action plan15 have been found to be associated with increased risk of ED return. In addition, risk of ED return for asthma has been shown to increase with age,18 particularly among seniors with low levels of family or community support.20