Prior research has documented the use of emergency departments as a source of both episodic, non-urgent primary care and urgent care for low income, uninsured, and persons with chronic health conditions. Many low-income persons are now required to enroll in Medicaid managed care through mandated, statewide initiatives. This provides challenges and opportunities to provide covered populations with access to and continuity of care, especially among persons with chronic conditions, such as asthma. This presentation examines ED use among children with and without asthma in a large metropolitan area and examines sociodemographic, health, and access correlates and predictors of ED use. Data for this presentation were collected through a representative community survey of 10,113 adults and 3,188 children (under 18 years) conducted in 2000 in the five-county Philadelphia metropolitan area. The survey instrument contains questions about health status, use of ambulatory and inpatient services, insurance status/type, and other measures of access. The data show that one out of ten children (10.0%) are asthmatic and more than one out of five children (23.7%) had at least one ED visit in the past year. More than two out of five children with asthma (43.9%) had at least one ED visit in the past year. Preliminary bivariate and multivariate analyses showed that age, race, and Medicaid status were strong predictors of ED use among asthmatic children, regardless of their managed care enrollment, insurance status, or having a usual source of care. The implications of these findings for patient outreach, education and care coordination are discussed. See phmc.org
Learning Objectives: 1. list the major predictors of ED use among children 2. understand mone methodological approach to examine ED use 3. apply this information in providing education, outreach, and case management to families with children with chronic health conditions
Keywords: Asthma, Emergency Department/Room
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.