Health Indicator Report of Asthma Hospitalizations

Notes

Asthma was identified using the the National Center for Health Statistics (NCHS) 113 selected causes asthma definition.   [[br]][[br]]Rates were age-adjusted to the U.S. 2000 standard population. As of October 1, 2015, the U.S. is currently using the 10th revision of the International Classification of Diseases (ICD-10) to code hospitalizations and emergency department visits. Prior to the change, asthma hospitalizations and emergency department visits were defined as having an ICD-9 primary diagnosis code of 493. In the ICD-10 classification asthma is defined using the J45 code. Comparison of data prior to the code change may not be appropriate. The decrease in asthma case counts from ICD-9 to ICD-10 in asthma-related hospitalizations and emergency department visits can be attributed to the availability of new codes as well as changes in coding guidelines and the CCS classification rules for chronic obstructive asthma. More information can be found here: [https://www.hcup-us.ahrq.gov/datainnovations/ICD-10_DXCCS_Trends112817.pdf]

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]

Definition

Rate: Number of hospitalizations due to asthma per 10,000 population.[[br]] Number: Number of hospitalizations due to asthma.

Numerator

Rate/Number: Number of hospitalizations among the Utah population with asthma as the principle diagnosis.

Denominator

Rate: Number of Utah residents.[[br]] Number: Not applicable.

How Are We Doing?

In 2022, Utah's overall age-adjusted asthma hospitalization rate was 3.2 visits per 10,000 people. There are specific groups with rates 3 to 5 times higher than the state rate. These include males aged 0-4 and 5-9 (14.9 and 12.7 per 10,000 people) and females aged 0-4 and 5-9 (9.3 and 8.8 per 10,000 people).

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 to 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.

Available Services

A list of Utah Asthma Program services for clinicians, community health workers, and people with asthma can be found here: [https://asthma.utah.gov/] Additionally, individual programs in the Office Health Promotion and Prevention provide information and education to citizens, physicians, and health care providers on chronic conditions. Resources can be found here: [https://dhhs.utah.gov/office-of-health-promotion-and-prevention/]

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]