WIP 160 - Establishing Care at Pediatric High-Risk Asthma Clinic

Poster Number: WIP 160
Publication Number: WIP 160.787

Background: Asthma is one of the most common pediatric diseases and a small subset of pediatric patients with asthma account for a disproportionate amount of asthma hospital admissions. These patients are often classified as having high-risk asthma: asthma prone to poor control from unaddressed modifiable factors or severe intrinsic disease. Successful management of high-risk asthma necessitates consistent access to ambulatory care. Multidisciplinary and mobile asthma clinics help address social and structural barriers to high-risk asthma management; however, many patients, despite receiving referrals to these clinics, do not successfully establish care. Factors related to patients establishing care are not well studied. Recognizing the factors that are associated with establishing care is critical to ensuring these patients receive high-quality asthma care.

Objective: To characterize the proportion of patients who attended their first appointment after referral to a high-risk asthma clinic at a large tertiary pediatric center
To identify factors associated with patients’ first appointment attendance
To compare asthma outcomes of patients who did and did not attend their first appointment at a high-risk asthma clinic

Design/Methods: Hospital IRB approval for this project was obtained (IRB 2020-3874). Patients referred to a high-risk asthma clinic from 1/2021-12/2022 were included in the study. A chart review was performed for eligible patients to extract relevant independent variables: age, race, ethnicity, insurance carrier, home address (to estimate distance from home to clinic), location of clinic (mobile vs hospital-based clinic), encounter with a high-risk asthma team member before referral, controller medication at the time referral, and asthma-related emergency department visits, admissions, and courses of oral steroids in the year before referral. Dependent variables included attendance at the first appointment, asthma-related emergency department visits, and admissions in the year following referral. Data analysis will be completed by March 2024.