Definition
Rate: Emergency department visits due to asthma per 10,000 Utah residents. [[br]]
Number: Emergency department visits due to asthma.Numerator
Rate/number: Number of emergency department visits among the Utah population with asthma as the principle diagnosis.Denominator
Rate: Utah population. [[br]]
Number: Not applicable.Data Interpretation Issues
Several studies unexpectedly found a reduction in pediatric asthma emergency department (ED) visits during the first year
of the COVID-19 pandemic in 2020 (1-3). These studies concluded public health measures like social distancing, mask-wearing, school closures, and stay-at-home orders resulted in reduced exposure to respiratory viruses and reduced asthma exacerbations, and therefore a decline in rates of asthma ED visits (1-3).
1. Arsenault S, Hoofman J, Poowuttikul P, Secord E. Sustained decrease in pediatric asthma emergency visits during the first year of the COVID-19
pandemic. Allergy Asthma Proc. 2021; 42(5): 400-402. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677502/]
2. Ulrich L, Macias C, George A, Bai S, Allen E. Unexpected decline in pediatric asthma morbidity during the coronavirus pandemic. Pediatric
Pulmonology. 2021; 56(7): 1951-1956. [https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.25406]
3. Akelma Z, Baskaya N, Cetin S, Bostanci I, Ozmen S. Improvement in school-aged children with asthma during the Covid-19 pandemic. Pediatric
Pulmonology. 2022; 57(10): 2518-2523. [https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.26068]Why Is This Important?
Asthma can usually be managed in an outpatient setting, reducing the need for emergency department visits. Tracking rates of emergency department visits can aid in identifying populations or areas with inadequate access to routine medical care.
An asthma attack can necessitate an emergency department visit and can be initiated by a variety of triggers. Some of these include exposure to environmental tobacco smoke, dust mites, cockroach allergen, mold, pets, strenuous physical exercise, and air pollution. Two key air pollutants that can affect asthma are ozone (found in smog) and PM or particulate matter (found in haze, smoke, and dust).
The majority of problems associated with asthma, including emergency department visits, are preventable if asthma is managed according to established guidelines. Effective management includes control of exposures to factors that trigger exacerbations, adequate pharmacological management, continual monitoring of the disease, and patient education in asthma care.How Are We Doing?
In 2022, Utah's overall emergency department visit rate due to asthma was 20.7 per 10,000 population (crude rate). Asthma emergency department visits per 10,000 were higher among male children aged 0-9 when compared to female children aged 0-9 (50.5 vs. 30.1). However, among those aged 10 years and older, females have a higher rate than males (20.8 vs. 13.7).What Is Being Done?
The Utah Asthma Program (UAP) works with the Utah Asthma Task Force and other partners to maximize the reach, impact, efficiency, and sustainability of comprehensive asthma control services in Utah. This is accomplished by providing a seamless alignment of asthma services across the public health and health care sector, ensuring that people with asthma receive all of the services they need.
The UAP focuses on building program infrastructure and implementing strategies that improve asthma control, reduce asthma-related emergency department visits and hospitalizations, and reduce health care costs. Program infrastructure is strengthened through a focus on strategies to create and support a comprehensive asthma control program, these strategies include: strengthening leadership, building strategic partnerships, and using strategic communication, surveillance, and evaluation. In addition, the UAP implements strategies outlined in the Centers for Disease Control and Prevention (CDC) EXHALE technical package to improve asthma control. The six strategy areas outlined in the EXHALE technical package are:[[br]]
1. Education on asthma self-management.[[br]]
2. e-Xtinguishing smoking and secondhand smoke.[[br]]
3. Home visits for trigger reduction and asthma self-management.[[br]]
4. Achievement of guidelines-based medical management.[[br]]
5. Linkages and coordination of care across settings.[[br]]
6. Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources.
These strategies are expected to improve asthma control and quality of life by increasing access to health care and increasing coordination and coverage for comprehensive asthma control services both in the public health and health care sectors. Specifically, these strategies include identifying people with poorly controlled asthma, linking them to health care providers and NAEPP EPR-3 guidelines-based care, educating them on asthma self-management strategies, providing a supportive school environment, and referring to or providing home trigger reduction services for those who need them.Health Program Information
Utah Asthma Program website: [https://asthma.utah.gov/]
CDC EXHALE package: [https://www.cdc.gov/national-asthma-control-program/php/exhale/index.html]
