Health Service Utilization and Poor Health Reporting in Asthma Patients
Abstract
:1. Introduction
2. Population and Design
2.1. Data Management and Analysis
2.2. Sample Characteristics
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Centers for Disease Control and Prevention. Learn How to Control Asthma, 2016. Available online: http://www.cdc.gov/asthma/faqs.htm (accessed on 22 April 2016).
- See, K.C.; Phua, J.; Lim, T.K. Trigger factors in asthma and chronic obstructive pulmonary disease: A single-centre cross-sectional study. Singapore Med. J. 2015, 11, 1–16. [Google Scholar] [CrossRef] [PubMed]
- WHO. World Health Organization Asthma Key Facts, 2016. Available online: http://www.who.int/mediacentre/factsheets/en/ (accessed on 1 June 2016).
- Stocks, S.J.; Bensefa-Colas, L.; Berk, S.F. Worldwide trends in incidence in occupational allergy and asthma. Curr. Opin. Allergy Clin. Immunol. 2016, 16, 113–119. [Google Scholar] [CrossRef] [PubMed]
- Anandan, C.; Nurmatov, U.; van Schayck, O.C.; Sheikh, A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy 2010, 65, 152–167. [Google Scholar] [CrossRef] [PubMed]
- Behavioral Risk Factor Surveillance System and Adult Asthma Prevalence 2013. Available online: http://www.cdc.gov/asthma/brfss/2013/tableC1.htm (accessed on 4 May 2016).
- Wilson, S.R.; Strub, P.; Buist, A.S.; Knowles, S.B.; Lavori, P.W.; Lapidus, J.; Vollmer, W.M. Shared treatment decision making improves adherence and outcomes in poorly controlled asthma. Am. J. Respir. Crit. Care Med. 2010, 181, 566–577. [Google Scholar] [CrossRef] [PubMed]
- Bender, B.G.; Bender, S.E. Patient-identified barriers to asthma treatment adherence: Responses to interviews, focus groups, and questionnaires. Immunol. Allergy Clin. N. Am. 2005, 25, 107–130. [Google Scholar] [CrossRef] [PubMed]
- Vollmer, W.M.; Markson, L.E.; O’Conner, E.; Sanocki, L.L.; Fitterman, L.; Berger, M.; Sonia Buist, A. Association of asthma control with health care utilization and quality of life. Am. J. Respir. Crit. Care Med. 1999, 160, 1647–1652. [Google Scholar] [CrossRef] [PubMed]
- Cowie, R.L.; Cowie, R.; Underwood, M.F.; Revitt, S.G.; Field, S.K. Predicting emergency department utilization in adults with asthma: A cohort study. J. Asthma 2001, 38, 179–184. [Google Scholar] [CrossRef] [PubMed]
- Van Schayck, C.; Chavannes, N. Detection of asthma and chronic obstructive pulmonary disease in primary care. Eur. Resp. J. 2003, 21, 16–22. [Google Scholar] [CrossRef]
- Ten Brinke, A.; Zwinderman, A.H.; Sterk, P.J.; Rabe, K.F.; Bel, E.H. Factors associated with persistent airflow limitation in severe asthma. Am. J. Respir. Crit. Care Med. 2001, 164, 744–748. [Google Scholar] [CrossRef] [PubMed]
- Goeman, D.P.; Aroni, R.A.; Stewart, K.; Sawyer, S.M.; Thien, F.; Abramson, M.J.; Douglass, J.A. Patients’ views of the burden of asthma: A qualitative study. Med. J. Australia 2002, 177, 295–299. [Google Scholar] [PubMed]
- Adams, R.J.; Smith, B.J.; Ruffin, R.E. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma. Thorax 2000, 55, 566–573. [Google Scholar] [CrossRef] [PubMed]
- Eisner, M.D.; Katz, P.P.; Yelin, E.H.; Shiboski, S.C.; Blanc, P.D. Risk factors for hospitalization among adults with asthma: The influence of sociodemographic factors and asthma severity. Respir. Res. 2000, 2, 53. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dales, R.; Schweitzer, I.; Kerr, P.; Gougeon, L.; Rivington, R.; Draper, J. Risk factors for recurrent emergency department visits for asthma. Thorax 1995, 50, 520–524. [Google Scholar] [CrossRef] [PubMed]
- Griswold, S.K.; Nordstrom, C.R.; Clark, S.; Gaeta, T.J.; Price, M.L.; Camargo, C.A. Asthma exacerbations in North American adults: Who are the “frequent fliers” in the emergency department? Chest J. 2005, 127, 1579–1586. [Google Scholar] [CrossRef] [PubMed]
- Dalcin, P.d.T.R.; Piovesan, D.M.; Kang, S.; Fernandes, A.K.; Franciscatto, E.; Millan, T.; Menna Barreto, S.S. Factors associated with emergency department visits due to acute asthma. Braz. J. Med. Biol. Res. 2004, 37, 1331–1338. [Google Scholar] [CrossRef] [PubMed]
- Kist Fernandes, A.; Mallmann, F.; Pasquali Steinhorst, A.M.; Lopes Nogueira, F.; Müller Ávila, E.; Zunino Saucedo, D.; Dalcin, P.D.T.R. Characteristics of acute asthma patients attended frequently compared with those attended only occasionally in an emergency department. J. Asthma 2003, 40, 683–690. [Google Scholar] [CrossRef]
- Erickson, S.; Tolstykh, I.; Selby, J.V.; Mendoza, G.; Iribarren, C.; Eisner, M.D. The impact of allergy and pulmonary specialist care on emergency asthma utilization in a large managed care organization. Health Serv. Res. 2005, 40, 1443–1465. [Google Scholar] [CrossRef] [PubMed]
- Shireman, T.I.; Heaton, P.C.; Gay, W.E.; Cluxton, R.J.; Moomaw, C.J. Relationship between asthma drug therapy patterns and healthcare utilization. Ann. Pharmacother. 2002, 36, 557–564. [Google Scholar] [CrossRef] [PubMed]
- Allen-Ramey, F.C.; Bukstein, D.; Luskin, A.; Sajjan, S.G.; Markson, L.E. Administrative claims analysis of asthma-related health care utilization for patients who received inhaled corticosteroids with either montelukast or salmeterol as combination therapy. J. Manag. Care Pharm. 2006, 12, 310–321. [Google Scholar] [CrossRef] [PubMed]
- Diette, G.B.; Krishnan, J.A.; Dominici, F.; Haponik, E.; Skinner, E.A.; Steinwachs, D.; Wu, A.W. Asthma in older patients: Factors associated with hospitalization. Arch. Intern. Med. 2002, 162, 1123–1132. [Google Scholar] [CrossRef] [PubMed]
- Osman, L.; Calder, C.; Godden, D.; Friend, J.; McKenzie, L.; Legge, J.; Douglas, J. A randomised trial of self-management planning for adult patients admitted to hospital with acute asthma. Thorax 2002, 57, 869–874. [Google Scholar] [CrossRef] [PubMed]
- Bender, B.G.; Rand, C. Medication non-adherence and asthma treatment cost. Curr. Opin. Allergy Clin. Immunol. 2004, 4, 191–195. [Google Scholar] [CrossRef] [PubMed]
- Barnes, P.; Jonsson, B.; Klim, J. The costs of asthma. Eur. Resp. J. 1996, 9, 636–642. [Google Scholar] [CrossRef]
- Heaney, L.G.; Robinson, D.S. Severe asthma treatment: Need for characterising patients. Lancet 2005, 365, 974–976. [Google Scholar] [CrossRef]
- Accordini, S.; Bugiani, M.; Arossa, W.; Gerzeli, S.; Marinoni, A.; Olivieri, M.; De Togni, A. Poor control increases the economic cost of asthma. Int. Arch. Allergy Immunol. 2006, 141, 189–198. [Google Scholar] [CrossRef] [PubMed]
- Pretty, J.; et al. The mental and physical health outcomes of green exercise. Int. J. Environ. Health Res. 2005, 15, 319–337. [Google Scholar] [CrossRef] [PubMed]
- Miller, G.; Chen, E.; Cole, S.W. Health psychology: Developing biologically plausible models linking the social world and physical health. Annu. Rev. Psychol. 2009, 60, 501–524. [Google Scholar] [CrossRef] [PubMed]
- Sawyer, M.; Spurrier, N.; Whaites, L.; Kennedy, D.; Martin, A.; Baghurst, P. The relationship between asthma severity, family functioning and the health-related quality of life of children with asthma. Qual. Life Res. 2000, 9, 1105–1115. [Google Scholar] [CrossRef] [PubMed]
- Ford, E.S.; Mannino, D.M.; Homa, D.M.; Gwynn, C.; Redd, S.C.; Moriarty, D.G.; Mokdad, A.H. Self-reported asthma and health-related quality of life: Findings from the behavioral risk factor surveillance system. Chest J. 2003, 123, 119–127. [Google Scholar] [CrossRef]
- Yen, I.H.; Yelin, E.H.; Katz, P.; Eisner, M.D.; Blanc, P.D. Perceived neighborhood problems and quality of life, physical functioning, and depressive symptoms among adults with asthma. Am. J. Public Health 2006, 96, 873–879. [Google Scholar] [CrossRef] [PubMed]
- Leynaert, B.; Neukirch, C.; Liard, R.; Bousquet, J.; Neukirch, F. Quality of life in allergic rhinitis and asthma: A population-based study of young adults. Am. J. Respir. Crit. Care Med. 2000, 162, 1391–1396. [Google Scholar] [CrossRef] [PubMed]
- Vortmann, M.; Eisner, M.D. BMI and health status among adults with asthma. Obesity 2008, 16, 146–152. [Google Scholar] [CrossRef] [PubMed]
- Ståhl, E.; Postma, D.; Juniper, E.; Svensson, K.; Mear, I.; Löfdahl, C.G. Health-related quality of life in asthma studies: Can we combine data from different countries? Pulm. Pharmacol. Ther. 2003, 16, 53–59. [Google Scholar] [CrossRef]
- Boulet, L.P. Asthma and obesity. Clin. Exp. Allergy 2013, 43, 8–21. [Google Scholar] [CrossRef] [PubMed]
- Beuther, D.A.; Weiss, S.T.; Sutherland, E.R. Obesity and asthma. Am. J. Respir. Crit. Care Med. 2006, 174, 112–119. [Google Scholar] [CrossRef] [PubMed]
- Cataletto, M. Asthma and obesity. Pediat. Allergy Immunol. Pulmonol. 2014, 27, 103. [Google Scholar] [CrossRef]
- Waggoner, D.; Stokes, J.; Casale, T.B. Asthma and obesity. Ann. Allergy Asthma Immunol. 2008, 101, 641–643. [Google Scholar] [CrossRef]
- Magid, D.J.; Houry, D.; Ellis, J.; Lyons, E.; Rumsfeld, J.S. Health-related quality of life predicts emergency department utilization for patients with asthma. Ann. Emerg. Med. 2004, 43, 551–557. [Google Scholar] [CrossRef] [PubMed]
- Eisner, M.D.; Ackerson, L.M.; Chi, F.; Kalkbrenner, A.; Buchner, D.; Mendoza, G.; Lieu, T. Health-related quality of life and future health care utilization for asthma. Ann. Allergy Asthma Immunol. 2002, 89, 46–55. [Google Scholar] [CrossRef]
- Schatz, M.; Zeiger, R.S.; Mosen, D.; Vollmer, W.M. Asthma-specific quality of life and subsequent asthma emergency hospital care. Am. J. Manag. Care 2008, 14, 206–211. [Google Scholar] [PubMed]
- Centers for Disease Control and Prevention. Adult asthma data: Prevalence tables. In Behavioral Risk Factor Surveillance System (BRFSS); Centers for Disease Control and Prevention: Atlanta, GA, USA, 2013. [Google Scholar]
- Behr, J.G.; Diaz, R. Emergency department frequent utilization for non-emergent presentments: Results from a regional urban trauma center study. PLoS ONE 2016, 11, 1–18. [Google Scholar] [CrossRef] [PubMed]
- Spillane, L.L.; Lumb, E.W.; Cobaugh, D.J.; Wilcox, S.R.; Clark, J.S.; Schneider, S.M. Frequent users of the emergency department: Can we intervene? Acad. Emerg. Med. 1997, 4, 574–580. [Google Scholar] [CrossRef] [PubMed]
- Chan, B.T.; Ovens, H.J. Frequent users of emergency departments: Do they also use family physicians’ services? Can. Fam. Phys. 2002, 48, 1654–1660. [Google Scholar]
- Locker, T.E.; Baston, S.; Mason, S.M.; Nicholl, J. Defining frequent use of an urban emergency department. Emerg. Med. J. 2007, 24, 398–401. [Google Scholar] [CrossRef] [PubMed]
- Hunt, K.A.; Weber, E.J.; Showstack, J.A.; Colby, D.C.; Callaham, M.L. Characteristics of frequent users of emergency departments. Ann. Emerg. Med. 2006, 48, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Fertel, B.S.; Hart, K.W.; Lindsell, C.J.; Ryan, R.J.; Lyons, M.S. Toward understanding the difference between using patients or encounters in the accounting of emergency department utilization. Ann. Emerg. Med. 2012, 60, 693–698. [Google Scholar] [CrossRef] [PubMed]
- National Hospital Ambulatory Medical Care Survey (NHAMCS): 2010 Emergency Department Summary Tables. Available online: https://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010 (accessed on 22 April 2016).
- Miller, J.E. The effects of race/ethnicity and income on early childhood asthma prevalence and health care use. Am. J. Public Health 2000, 90, 428. [Google Scholar] [PubMed]
- Knowlton, A.; Weir, B.W.; Hughes, B.S.; Southerland, R.; Schultz, C.W.; Sarpatwari, R.; McWilliams, J. Patient demographic and health factors associated with frequent use of emergency medical services in a midsized city. Acad. Emerg. Med. 2013, 20, 1101–1111. [Google Scholar] [CrossRef] [PubMed]
- Fan, L.; Shah, M.N.; Veazie, P.J.; Friedman, B. Factors associated with emergency department use among the rural elderly. J. Rural Health 2011, 27, 39–49. [Google Scholar] [CrossRef] [PubMed]
- Baker, D.W.; Parker, R.M.; Williams, M.V.; Clark, W.S.; Nurss, J. The relationship of patient reading ability to self-reported health and use of health services. Am. J. Public Health 1997, 87, 1027–1030. [Google Scholar] [CrossRef] [PubMed]
- Baker, D.W.; Stevens, C.D.; Brook, R.H. Regular source of ambulatory care and medical care utilization by patients presenting to a public hospital emergency department. J. Am. Med. Assn. 1994, 271, 1909–1912. [Google Scholar] [CrossRef]
Descriptive Varriable & Attibutes | Combined | Diagnosed Asthma | No Reported Asthma | |||
---|---|---|---|---|---|---|
No. (%) | No. (%) | No. (%) | ||||
Gender | ||||||
Male | 532 | (31.7) | 27 | (18.2) | 505 | (33.0) |
Female | 1146 | (68.3) | 121 | (81.8) | 1025 | (67.0) |
Age (year) | ||||||
29 years or less | 260 | (15.5) | 32 | (21.6) | 228 | (14.9) |
30 to 39 years | 296 | (17.6) | 22 | (14.9) | 274 | (17.9) |
40 to 49 years | 378 | (22.5) | 26 | (17.6) | 352 | (23.0) |
50 to 59 years | 335 | (20.0) | 28 | (18.9) | 307 | (20.1) |
60 or more years | 392 | (23.4) | 38 | (25.7) | 354 | (23.1) |
Refuse | 17 | (1.0) | 2 | (1.4) | 15 | (1.0) |
Race/Ethnicity | ||||||
White/Anglo/Caucasian | 1190 | (70.9) | 89 | (60.1) | 1101 | (72.0) |
Black/African American | 383 | (22.8) | 50 | (33.8) | 333 | (21.8) |
Hispanic/Latin American | 31 | (1.9) | 4 | (2.7) | 27 | (1.8) |
Asian/Pacific Islander | 24 | (1.4) | 2 | (1.4) | 22 | (1.4) |
Other | 39 | (2.4) | 3 | (2.0) | 36 | (2.4) |
Refuse | 10 | (0.7) | 0 | (0.0) | 10 | (0.7) |
Utilization Type & Frequency | Odds Ratio | 95% CI | C&S 1, Nag. 2 | p Sig. 3 |
---|---|---|---|---|
Primary Care | ||||
1 or more visits | 4.23 | 1.56–11.69 | 0.008, 0.017 | 0.005 |
2 or more visits | 4.71 | 1.72–12.90 | 0.011, 0.023 | 0.003 |
3 or more visits | 5.41 | 1.97–14.88 | 0.016, 0.034 | 0.001 |
4 or more visits | 5.79 | 2.09–16.01 | 0.022, 0.045 | 0.001 |
5 or more visits | 5.93 | 2.12–16.54 | 0.028, 0.058 | 0.001 |
Emergency Department | ||||
1 or more visits | 1.87 | 1.32–2.65 | 0.007, 0.016 | 0.000 |
2 or more visits | 3.57 | 2.35–5.40 | 0.022, 0.049 | 0.000 |
3 or more visits | 3.47 | 1.97–6.09 | 0.012, 0.027 | 0.000 |
4 or more visits | 5.33 | 2.70–10.54 | 0.014, 0.033 | 0.000 |
5 or more visits | 6.35 | 2.99–13.52 | 0.014, 0.034 | 0.000 |
Hospital Stays | ||||
1 or more days | 2.21 | 1.39–3.50 | 0.009, 0.018 | 0.001 |
2 or more days | 3.10 | 1.85–5.19 | 0.015, 0.030 | 0.000 |
3 or more days | 3.53 | 2.00–6.22 | 0.015, 0.031 | 0.000 |
4 or more days | 2.33 | 1.09–4.97 | 0.004, 0.008 | 0.029 |
5 or more days | 2.81 | 1.25–6.35 | 0.005, 0.011 | 0.013 |
Physical Health & Frequency | Odds Ratio | 95% CI | C&S 1, Nag. 2 | p Sig. 3 |
---|---|---|---|---|
Health Not Good | ||||
1 or more days | 1.37 | 0.97–1.95 | 0.002, 0.004 | 0.078 † |
2 or more days | 1.50 | 1.05–2.15 | 0.003, 0.007 | 0.026 |
3 or more days | 1.64 | 1.21–2.39 | 0.004, 0.009 | 0.011 |
4 or more days | 1.66 | 1.11–2.48 | 0.004, 0.009 | 0.014 |
5 or more days | 1.78 | 1.18–2.68 | 0.005, 0.011 | 0.006 |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Behr, J.G.; Diaz, R.; Akpinar-Elci, M. Health Service Utilization and Poor Health Reporting in Asthma Patients. Int. J. Environ. Res. Public Health 2016, 13, 645. https://doi.org/10.3390/ijerph13070645
Behr JG, Diaz R, Akpinar-Elci M. Health Service Utilization and Poor Health Reporting in Asthma Patients. International Journal of Environmental Research and Public Health. 2016; 13(7):645. https://doi.org/10.3390/ijerph13070645
Chicago/Turabian StyleBehr, Joshua G., Rafael Diaz, and Muge Akpinar-Elci. 2016. "Health Service Utilization and Poor Health Reporting in Asthma Patients" International Journal of Environmental Research and Public Health 13, no. 7: 645. https://doi.org/10.3390/ijerph13070645