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Child/Adolescent Health

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Having a usual source of care increases wellness visits among children with asthma

Childhood asthma is a chronic inflammatory disease that requires the child and family to monitor symptoms daily and regularly evaluate the effects of treatment with a health care provider in order to avoid acute breathing problems that may lead to emergency department (ED) visits. According to a study supported in part by the Agency for Healthcare Research and Quality (HS13110), children with asthma who have a usual source of care (USC) are twice as likely as those without one to have a wellness examination during the course of a year. They are also more likely to fill or refill a rescue bronchodilator prescription to use in case of an asthma flareup to help prevent trips to the ED. Having a USC, however, is not significantly related to asthma-related ED use.

Researchers analyzed data from the 1996-2000 Medical Expenditure Panel Survey, an ongoing, nationally representative survey of the U.S. population on the financing and use of medical care. This study focused on the wellness visits, bronchodilator fills/refills, and ED visits of 1,726 children with asthma and their usual source of care (including characteristics such as ease of getting an appointment on short notice).

Overall, 95 percent of children had a USC. Half (51 percent) of the children used a USC which was reported to be a facility (doctor's office, health center, or clinic) rather than a named person. Most parents (82 percent) were very satisfied with the quality of care received at the USC. Over the calendar year, 10 percent of children made at least one asthma-related visit to the ED, 40 percent had at least one wellness visit, and 50 percent filled a rescue bronchodilator prescription.

See "Presence and characteristics of medical home and health services utilization among children with asthma," by Gail M. Kieckhefer, Ph.D., A.R.N.P., April A. Greek, Ph.D., Jutta M. Joesch, Ph.D., and others in the September 2005 Journal of Pediatric Health Care 19(5), pp. 285-292.

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