Montefiore in the News
Health Care Utilization Improvements in Urban Minority Youth Tied to Better Asthma Control
- May 30, 2022
SAN FRANCISCO — In urban minority children with a high asthma burden, improvement in healthcare utilization rates was tied with better asthma control, according to research presented at the American Thoracic Society International Conference.
“In urban minority children with high asthma disease burden, rates of health care utilization, including hospitalizations, emergency department visits, urgent care visits and sick office visits, decreased significantly as a result of the COVID-19 pandemic. During this time, despite improvements in asthma control symptoms, there was no change in spirometry findings, suggesting that such changes did not impact lung function,” Ye Sun, MD, MPH, from the division of pediatrics at the Children’s Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York, told Healio. Sun and colleagues conducted a study to assess changes in health care utilization after the COVID-19 stay-at-home orders among patients in the multidisciplinary Asthma Center at the Children’s Hospital at Montefiore in the Bronx, New York. “We know that the COVID-19 pandemic caused dramatic changes in health care access and utilization. Various studies have found that overall rates of asthma-related hospitalizations and emergency room visits decreased,” Sun told Healio. “However, few have looked at children with poorly controlled, persistent asthma, and little is known about how lung function changed during this time.” The retrospective cohort study included 101 children and young adults aged 2 to 21 years (mean age, 9.1 years; 53.5% male; 61.4% Hispanic; 27.7% Black) with physician-diagnosed persistent asthma. All patients had at least one visit before and after the COVID-19 shutdown, which occurred in this region from March to June 2020. At the initial visit, 23.8% of patients had mild persistent asthma, 56.4% had moderate persistent asthma and 19.8% had severe persistent asthma. The average length of time between visits was 323.5 days. Researchers observed significant decreases for all outcomes from before and after the COVID-19 shutdown, with an average decrease of 76% for hospitalization rates, 69% for ED visits and 8% for oral steroid use. These decreases were associated with asthma control improvement based on the Asthma Control Test score or NHLBI questionnaire (57% vs. 24% not controlled; P < .001). The researchers reported no significant improvement in FEV1, FEV1/FVC ratios or FEF25%-75% before the COVID-19 shutdown compared with after the shutdown. “Our findings were surprising because this suggests improvement in utilization during this time did not seem to impact lung function, which could potentially contribute to further exacerbations post-COVID shutdown,” Sun told Healio. The researchers plan to study this further to elucidate factors that contributed to change in utilization during the shutdown, including allergen sensitization, weight change and viral exposure, Sun said.