Reducing Emergency Department Visits and Hospitalizations in African American and Hispanic Patients with Asthma: A 15-Year Review

Abstract

Minority populations in the United States continue to experience a disproportionate share of emergency department (ED) visits and hospitalizations due to asthma. This review examines programs that have attempted to reduce these acute care visits in African American and Hispanic patients. We performed a PubMed search of the English literature for studies published from March 1990 to March 2005, aimed at reducing ED visits and hospitalizations in patients with asthma. Decreased acute care visits in African American and Hispanic patients with asthma have been demonstrated in several studies over the past 15 years, including collaboration by physicians, nurses, and clinical pharmacists in achieving this goal. These studies have shown that reduced acute care visits are associated with optimal drug therapy per national guidelines, concurrent with patient education, environmental control, and objective monitoring of this inflammatory airway disease. Early intensive patient education was a key feature of these successful programs. Written action plans, including early use of oral corticosteroids at home, and rapport with patients are other key components of programs that have resulted in a decrease in ED visits and hospitalizations.

Race/ethnicity and asthma management among adults presenting to the emergency department

“…Our observations should prompt further investigation of the causes of health-care barriers in this population. 1,2 In this study of US adults requiring acute ED asthma management, NHB, even with increased chronic asthma morbidity, was only as likely as NHW or Hispanics to utilize evidence-based controller medications or see asthma specialists before ED presentation or be newly prescribed indicated ICS at ED discharge, similar to our 2003 results. 3 For practitioners and researchers, the implications are that improvement in ED patient and provider education on evidence-based chronic disease management are needed to address continuing race/ethnicity-based asthma disparities.…”

“…1 Understanding that asthma disproportionately affects US minorities, investigators have published interventions to improve management and outcomes in these populations. 2 Whether efforts to improve minority patients' asthma care have disseminated into day-to-day chronic and acute asthma management is unclear.…”

Impact of an asthma management program on hospitalizations and emergency department visits

“…A escolha do desenho, controle histórico, mesmo com limitações, impôs-se frente às dificuldades de desenvolver um estudo de avaliação em uma cidade com a complexidade de Belo Horizonte, além de ser apontado por Gordis 14 hospitalização e de atendimentos de urgência como parâ-metros para avaliar tratamentos preventivos na asma 6,[16][17][18][19][20][21][22][23][24] . Por outro lado, essas variáveis são quantificáveis e também fatos marcantes na vida do paciente, reduzindo o viés de memória 25,26 .…”

Racial and Ethnic Disparities in Current Asthma and Emergency Department Visits: Findings from the National Health Interview Survey, 2001–2010

“…It is important to note that minorities are more likely to have uncontrolled or severe asthma which may result in their overuse of the emergency department. 15 Factors associated with uncontrolled or severe asthma among minorities include: genetic and environmental risk factors, poor access to health care, socioeconomic status, and cultural beliefs. 6 Previous studies have reported that blacks and Hispanics rely less on routine care and more on emergency care for asthma.…”