Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool- and school-aged children
Background In children, hospitalization for asthma is reported to have a distinct seasonal pattern with peaks coincident with the start of school. Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medicat...
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Veröffentlicht in: | Annals of allergy, asthma, & immunology asthma, & immunology, 2009-03, Vol.102 (3), p.198-204 |
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description | Background In children, hospitalization for asthma is reported to have a distinct seasonal pattern with peaks coincident with the start of school. Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medication use. Objective To describe seasonal patterns of asthma-related health care use and asthma controller and reliever medication claims in children. Methods An ecological analysis was conducted of data collected from records for children aged 2 to 12 years from 2002 through 2004 from an automated research database of insurance claims from a large US health care plan. Seasonal patterns for health care use and estimates of prescription asthma controller and reliever use were determined for preschool-aged children (aged 2–5 years) and school-aged children (aged 6–12 years). Rates were constructed by week; deviations from annual mean rates were used to determine peaks in use. Results were confirmed using Poisson regression models, modeling for rates within age group, with factors for week, year, and regions. Results Emergency department and outpatient visits and hospitalizations were lowest during summer; rates increased beginning in September, peaking in October or November. Asthma controller and reliever medication claims increased beginning in September, peaking in December. Rates also were elevated in February. Conclusions The data suggest that children who reduce their asthma medications during the summer do not resume taking medications until signs or symptoms of asthma worsen. The summer hiatus and other factors may contribute to seasonal increases in health care use and in asthma medication prescriptions, particularly in the fall. |
doi_str_mv | 10.1016/S1081-1206(10)60081-6 |
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Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medication use. Objective To describe seasonal patterns of asthma-related health care use and asthma controller and reliever medication claims in children. Methods An ecological analysis was conducted of data collected from records for children aged 2 to 12 years from 2002 through 2004 from an automated research database of insurance claims from a large US health care plan. Seasonal patterns for health care use and estimates of prescription asthma controller and reliever use were determined for preschool-aged children (aged 2–5 years) and school-aged children (aged 6–12 years). Rates were constructed by week; deviations from annual mean rates were used to determine peaks in use. Results were confirmed using Poisson regression models, modeling for rates within age group, with factors for week, year, and regions. Results Emergency department and outpatient visits and hospitalizations were lowest during summer; rates increased beginning in September, peaking in October or November. Asthma controller and reliever medication claims increased beginning in September, peaking in December. Rates also were elevated in February. Conclusions The data suggest that children who reduce their asthma medications during the summer do not resume taking medications until signs or symptoms of asthma worsen. The summer hiatus and other factors may contribute to seasonal increases in health care use and in asthma medication prescriptions, particularly in the fall.</description><identifier>ISSN: 1081-1206</identifier><identifier>EISSN: 1534-4436</identifier><identifier>DOI: 10.1016/S1081-1206(10)60081-6</identifier><identifier>PMID: 19354065</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Factors ; Allergy and Immunology ; Ambulatory Care - statistics & numerical data ; Anti-Asthmatic Agents - therapeutic use ; Asthma - drug therapy ; Asthma - epidemiology ; Biological and medical sciences ; Child ; Child, Preschool ; Chronic obstructive pulmonary disease, asthma ; Databases, Factual ; Delivery of Health Care - utilization ; Dermatology ; Emergency Medical Services - statistics & numerical data ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Health Care Surveys ; Hospitalization - statistics & numerical data ; Humans ; Medical sciences ; Pneumology ; Prescriptions - statistics & numerical data ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Seasons ; United States - epidemiology</subject><ispartof>Annals of allergy, asthma, & immunology, 2009-03, Vol.102 (3), p.198-204</ispartof><rights>American College of Allergy, Asthma & Immunology</rights><rights>2009 American College of Allergy, Asthma & Immunology</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-57203419de4219a2e82e56d07305bb5cb60443b374f95da8bc04c902cd8ac8f73</citedby><cites>FETCH-LOGICAL-c479t-57203419de4219a2e82e56d07305bb5cb60443b374f95da8bc04c902cd8ac8f73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S1081-1206(10)60081-6$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21231010$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19354065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Dole, Kristen B., MSPH</creatorcontrib><creatorcontrib>Swern, Arlene S., PhD</creatorcontrib><creatorcontrib>Newcomb, Kathleen</creatorcontrib><creatorcontrib>Nelsen, Linda, MHS</creatorcontrib><title>Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool- and school-aged children</title><title>Annals of allergy, asthma, & immunology</title><addtitle>Ann Allergy Asthma Immunol</addtitle><description>Background In children, hospitalization for asthma is reported to have a distinct seasonal pattern with peaks coincident with the start of school. Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medication use. Objective To describe seasonal patterns of asthma-related health care use and asthma controller and reliever medication claims in children. Methods An ecological analysis was conducted of data collected from records for children aged 2 to 12 years from 2002 through 2004 from an automated research database of insurance claims from a large US health care plan. Seasonal patterns for health care use and estimates of prescription asthma controller and reliever use were determined for preschool-aged children (aged 2–5 years) and school-aged children (aged 6–12 years). Rates were constructed by week; deviations from annual mean rates were used to determine peaks in use. Results were confirmed using Poisson regression models, modeling for rates within age group, with factors for week, year, and regions. Results Emergency department and outpatient visits and hospitalizations were lowest during summer; rates increased beginning in September, peaking in October or November. Asthma controller and reliever medication claims increased beginning in September, peaking in December. Rates also were elevated in February. Conclusions The data suggest that children who reduce their asthma medications during the summer do not resume taking medications until signs or symptoms of asthma worsen. The summer hiatus and other factors may contribute to seasonal increases in health care use and in asthma medication prescriptions, particularly in the fall.</description><subject>Age Factors</subject><subject>Allergy and Immunology</subject><subject>Ambulatory Care - statistics & numerical data</subject><subject>Anti-Asthmatic Agents - therapeutic use</subject><subject>Asthma - drug therapy</subject><subject>Asthma - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Databases, Factual</subject><subject>Delivery of Health Care - utilization</subject><subject>Dermatology</subject><subject>Emergency Medical Services - statistics & numerical data</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Health Care Surveys</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Pneumology</subject><subject>Prescriptions - statistics & numerical data</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Seasons</subject><subject>United States - epidemiology</subject><issn>1081-1206</issn><issn>1534-4436</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkrmO0DAQhiMEYg94BJAbEBSB8ZmkAaHVckgrUSzUluNMiJfECXaCtBWvjnMAEs1WHo-_-cee31n2hMIrClS9vqZQ0pwyUC8ovFSw7tS97JRKLnIhuLqf4j_ISXYW4w0A0FLxh9kJrbgUoORp9usaTRy96clk5hmDj8R50qHp545YE5AsEYnxDZk6EwZjcZmdTbjtjRsiacdATJy7wZApYLTBTbMb_X6wZbpx7PNN4YjNN2yI7VzfBPSPsget6SM-Ptbz7Ov7yy8XH_Orzx8-Xby7yq0oqjmXBQMuaNWgYLQyDEuGUjVQcJB1LW2tIL255oVoK9mYsrYgbAXMNqWxZVvw8-z5rjuF8ceCcdaDixb73ngcl6hVQZkqJbsTZCB5KSRPoNxBG8YYA7Z6Cm4w4VZT0KtFerNIr_NfU5tFWqW6p0eDpR6w-Vd1eJKAZwdgYpp0G4y3Lv7lGGU8yUPi3u4cprn9dBh0tA69xcYFtLNuRnfnVd78p2B751d7v-MtxptxCelnRE11ZBp2kVWDwqag-G_qq8Mo</recordid><startdate>20090301</startdate><enddate>20090301</enddate><creator>Van Dole, Kristen B., MSPH</creator><creator>Swern, Arlene S., PhD</creator><creator>Newcomb, Kathleen</creator><creator>Nelsen, Linda, MHS</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20090301</creationdate><title>Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool- and school-aged children</title><author>Van Dole, Kristen B., MSPH ; Swern, Arlene S., PhD ; Newcomb, Kathleen ; Nelsen, Linda, MHS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-57203419de4219a2e82e56d07305bb5cb60443b374f95da8bc04c902cd8ac8f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Age Factors</topic><topic>Allergy and Immunology</topic><topic>Ambulatory Care - statistics & numerical data</topic><topic>Anti-Asthmatic Agents - therapeutic use</topic><topic>Asthma - drug therapy</topic><topic>Asthma - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Databases, Factual</topic><topic>Delivery of Health Care - utilization</topic><topic>Dermatology</topic><topic>Emergency Medical Services - statistics & numerical data</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Health Care Surveys</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Pneumology</topic><topic>Prescriptions - statistics & numerical data</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Seasons</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Dole, Kristen B., MSPH</creatorcontrib><creatorcontrib>Swern, Arlene S., PhD</creatorcontrib><creatorcontrib>Newcomb, Kathleen</creatorcontrib><creatorcontrib>Nelsen, Linda, MHS</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of allergy, asthma, & immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Dole, Kristen B., MSPH</au><au>Swern, Arlene S., PhD</au><au>Newcomb, Kathleen</au><au>Nelsen, Linda, MHS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool- and school-aged children</atitle><jtitle>Annals of allergy, asthma, & immunology</jtitle><addtitle>Ann Allergy Asthma Immunol</addtitle><date>2009-03-01</date><risdate>2009</risdate><volume>102</volume><issue>3</issue><spage>198</spage><epage>204</epage><pages>198-204</pages><issn>1081-1206</issn><eissn>1534-4436</eissn><abstract>Background In children, hospitalization for asthma is reported to have a distinct seasonal pattern with peaks coincident with the start of school. Although guidelines indicate that asthma controller medications should be used daily, there is limited information on actual seasonal patterns of medication use. Objective To describe seasonal patterns of asthma-related health care use and asthma controller and reliever medication claims in children. Methods An ecological analysis was conducted of data collected from records for children aged 2 to 12 years from 2002 through 2004 from an automated research database of insurance claims from a large US health care plan. Seasonal patterns for health care use and estimates of prescription asthma controller and reliever use were determined for preschool-aged children (aged 2–5 years) and school-aged children (aged 6–12 years). Rates were constructed by week; deviations from annual mean rates were used to determine peaks in use. Results were confirmed using Poisson regression models, modeling for rates within age group, with factors for week, year, and regions. Results Emergency department and outpatient visits and hospitalizations were lowest during summer; rates increased beginning in September, peaking in October or November. Asthma controller and reliever medication claims increased beginning in September, peaking in December. Rates also were elevated in February. Conclusions The data suggest that children who reduce their asthma medications during the summer do not resume taking medications until signs or symptoms of asthma worsen. The summer hiatus and other factors may contribute to seasonal increases in health care use and in asthma medication prescriptions, particularly in the fall.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19354065</pmid><doi>10.1016/S1081-1206(10)60081-6</doi><tpages>7</tpages></addata></record> |
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subjects | Age Factors Allergy and Immunology Ambulatory Care - statistics & numerical data Anti-Asthmatic Agents - therapeutic use Asthma - drug therapy Asthma - epidemiology Biological and medical sciences Child Child, Preschool Chronic obstructive pulmonary disease, asthma Databases, Factual Delivery of Health Care - utilization Dermatology Emergency Medical Services - statistics & numerical data Fundamental and applied biological sciences. Psychology Fundamental immunology Health Care Surveys Hospitalization - statistics & numerical data Humans Medical sciences Pneumology Prescriptions - statistics & numerical data Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Seasons United States - epidemiology |
title | Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool- and school-aged children |
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