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
Hauptverfasser: Van Dole, Kristen B., MSPH, Swern, Arlene S., PhD, Newcomb, Kathleen, Nelsen, Linda, MHS
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container_issue 3
container_start_page 198
container_title Annals of allergy, asthma, & immunology
container_volume 102
creator Van Dole, Kristen B., MSPH
Swern, Arlene S., PhD
Newcomb, Kathleen
Nelsen, Linda, MHS
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 &amp; 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 &amp; numerical data ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Health Care Surveys ; Hospitalization - statistics &amp; numerical data ; Humans ; Medical sciences ; Pneumology ; Prescriptions - statistics &amp; numerical data ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. 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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><subject>Age Factors</subject><subject>Allergy and Immunology</subject><subject>Ambulatory Care - statistics &amp; 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 &amp; numerical data</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Health Care Surveys</subject><subject>Hospitalization - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Pneumology</subject><subject>Prescriptions - statistics &amp; numerical data</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. 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Psychology</topic><topic>Fundamental immunology</topic><topic>Health Care Surveys</topic><topic>Hospitalization - statistics &amp; numerical data</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Pneumology</topic><topic>Prescriptions - statistics &amp; 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, &amp; 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, &amp; 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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