The identification of high risk asthmatic children using the emergency department asthma visit count

A subset of asthma patients accounts for a disproportionate amount of healt h care resources through repeat visits. A retrospective analysis of emergen cy department (ED) billing and admission databases was performed to assess the value of the asthma visit count as an indicator of future health care u tilization. The asthma visit count was found to have a direct and linear re lationship with both future ED visits and future inpatient admission for as thma, Children with 2 visits in 1997 had a substantial (26.9%) risk of retu rning in the 1998 study period, and a 6.6% risk of admission. Children who visited the ED 3 or more times in 1997 for asthma had a risk of repeat visi t of more than 52%, and more than 12% of this highest risk group were admit ted to the hospital at least once during the 1998 study period. Once an ann ual asthma visit count of 3 or more is achieved, there can be little contro versy with the "high utilizer" label. The substantial increase in the visit and admission risk warrants consideration of the asthma visit count as an easily obtainable, objective marker to identify high-risk children for both study and clinical purposes. Further research is needed. (C) 1999 Elsevier Science Inc.