National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- (-) Asthma (11)
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- Provider: Physician (1)
- Quality Improvement (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedCampbell JI, Dubois MM, Savage TJ
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
This study’s objective was to identify subgroups likely to benefit from monoclonal antibody and antiviral therapy to treat COVID-19 by evaluating the relationship between comorbidities and hospitalization among US adolescents aged 12-17 with symptomatic coronavirus disease 2019 (COVID-19). The authors used the Pediatric COVID-19 US registry to identify patients who met their inclusion criteria of comorbidities including obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). Out of 1877 total patients included 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. The following comorbidities were associated with increased odds of hospitalization: SCD, immunocompromising condition, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma).
AHRQ-funded; HS000063.
Citation: Campbell JI, Dubois MM, Savage TJ .
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
J Pediatr 2022 Jun;245:102-10.e2. doi: 10.1016/j.jpeds.2022.02.048..
Keywords: Children/Adolescents, Diabetes, Asthma, Kidney Disease and Health, Hospitalization
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Oka S, Goto T, Hirayama A
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Researchers investigated the association of obstructive sleep apnea (OSA) with acute asthma severity in a retrospective cohort study that used State Inpatient Databases from eight geographically diverse states. Outcomes examined were markers of acute severity such as mechanical ventilation use, hospital length of stay, and in-hospital mortality. The researchers found that, among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
AHRQ-funded; HS023305.
Citation: Oka S, Goto T, Hirayama A .
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Asthma, Respiratory Conditions, Hospitalization
Goldstein E, Finelli L, O'Halloran A
AHRQ Author: Karaca Z, Steiner C
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
This study examined hospitalization rates in children associated with respiratory syncytial virus (RSV) and influenza, including children with asthma. HCUP hospitalization data and additional data to estimate RSV and influenza-associated hospitalization with a respiratory cause was analyzed in different subpopulations of US children between 2003 and 2010. Annual rates of RSV-associated hospitalization was highest in infants and young children, and declined rapidly with age. Influenza hospitalizations also were highest in young children and declined by age 12-17 years. Higher rates of RSV-related and influenza hospitalization in the youngest children with a prior diagnosis of asthma was also found.
AHRQ-authored.
Citation: Goldstein E, Finelli L, O'Halloran A .
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
Epidemiology 2019 Nov;30(6):918-26. doi: 10.1097/ede.0000000000001092..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Asthma, Influenza, Respiratory Conditions, Hospitalization, Chronic Conditions
Parikh K, Paul J, Foushee N
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
This study focused on developing a comprehensive understanding of asthma care after hospitalization of children as reported by caregivers, health providers, and school nurses. The children had a median age of 7 years, mean hospital length of stay of 1.9 days, and 56% had a previous hospitalization in the last 12 months. Family caregivers and health professionals were given individual interviews while focus groups were conducted with school nurses. There were different health beliefs about asthma knowledge between caregivers and health professionals. School nurses highlighted specific barriers that focused on medication use in schools.
AHRQ-funded; HS024554.
Citation: Parikh K, Paul J, Foushee N .
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
Hosp Pediatr 2018 Nov;8(11):706-17. doi: 10.1542/hpeds.2017-0182..
Keywords: Asthma, Hospitalization, Children/Adolescents, Caregiving, Patient Adherence/Compliance, Education
Luthe SK, Hirayama A, Goto T
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
This study examined the association between obesity and exacerbation of asthma symptoms in hospitalized adults (age 18-54 years). This retrospective cohort study used data from 8 diverse US states from 2010-2013. Among 72,086 patients hospitalized for asthma exacerbation, 24% were considered obese. Obesity was associated with a higher use of mechanical ventilation as well as a longer hospital stay. These findings were consistent among all ages, sex, and race/ethnicity.
AHRQ-funded; HS023305.
Citation: Luthe SK, Hirayama A, Goto T .
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):1936-41.e4. doi: 10.1016/j.jaip.2018.02.001..
Keywords: Asthma, Hospitalization, Obesity, Respiratory Conditions
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
Parikh K, Keller S, Ralston S
Inpatient quality improvement interventions for asthma: a meta-analysis.
This article reviewed interventional studies of inpatient-initiated asthma quality improvement (QI) to synthesize its impact on health care utilization. Thirty articles were included; 12 provided data on health care reutilization outcomes. The selected studies were categorized by intervention type and outcome. Risk ratios for readmissions were examined and a subanalyis of multimodal interventions conducted; the latter suggested lower readmission rates. A subanalysis of education and discharge planning interventions did not show an effect. The authors did not identify any inpatient strategies that impacted health care reutilization within 30 days of index hospitalization, but note that multimodal interventions demonstrated impact over the longer interval.
AHRQ-funded; HS024554.
Citation: Parikh K, Keller S, Ralston S .
Inpatient quality improvement interventions for asthma: a meta-analysis.
Pediatrics 2018 May;141(5). doi: 10.1542/peds.2017-3334.
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Keywords: Asthma, Children/Adolescents, Hospitalization, Inpatient Care, Quality Improvement
Stone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research