By Cortney Bruno

Children with asthma often visit the emergency department or are admitted to the hospital, but some of these costly visits may be avoidable. That’s why practitioners, researchers, and policymakers are interested in interventions that help kids control their asthma while preventing avoidable hospital use. The challenge is figuring out which intervention will work best for which child. Identifying subgroups of children with asthma who have similar utilization patterns was the focus of an Annals of Emergency Medicine article written by staff from Camden Coalition of Healthcare Providers, University of Michigan, and RAND Corporation.

The authors used hospital claims data to identify subgroups based on how and when children visited the emergency department or were admitted to the hospital. They also identified external factors that were common among children in each cluster. These findings had implications for designing effective interventions: patients from one cluster, for example, used the hospital more during the winter months; a seasonal intervention might work well for those children.

“Tailored approaches can help improve outcomes and reduce health care costs,” said Mahshid Abir, lead author on the study. In Camden, where nearly a third of children are affected by asthma, and asthma-related hospital visits increased by 95% over a ten-year period, customized interventions could create substantial impact on avoidable emergency department use and inpatient stays.

Identifying patient clusters was only the first phase of this project. Based on their findings, the authors researched existing evidence-based interventions for children with asthma. They knew that, to design truly effective interventions, seeking input from the community would be key. The authors held focus groups with community members in which they shared their findings solicited feedback on what types of interventions might work for children in Camden. Local providers worked with the researchers to analyze the information collected in the focus groups, with the hope that their buy-in will mean that the findings can effect real change for asthmatic children in Camden. The authors hope to publish the results from these later phases of the project soon in another peer-reviewed journal article.

Read the full publication: Cluster Analysis of Acute Care Use Yields Insights for Tailored Pediatric Asthma Interventions.

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