{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:14:40Z","timestamp":1771046080539,"version":"3.50.1"},"reference-count":31,"publisher":"American Academy of Pediatrics (AAP)","issue":"Supplement_2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,4,1]]},"abstract":"<jats:p>OBJECTIVES. Asthma is one of the more common reasons for children's visits to the emergency departments (EDs). Many studies show that the level of asthma care and self-management in children before an ED visit for asthma is often inadequate; however, most of these studies have been conducted in the inner cities of large urban areas. Our objectives were to describe asthma care and management in children treated for asthma in 3 EDs located in an urban, suburban, or rural setting.<\/jats:p><jats:p>METHODS. We studied a prospective patient cohort consisting of children aged 2 to 17 years who presented with an acute asthma exacerbation at 3 EDs in western Michigan. An in-person questionnaire was administered to the parent or guardian during the ED visit. Information was collected on demographics; asthma history; usual asthma care; frequency of symptoms during the last 4 weeks; current asthma treatment, management, and control; and past emergency asthma care. A telephone interview conducted 2 weeks after the ED visit obtained follow-up information. The 8 quality indicators of asthma care and management were defined based on recommendations from national guidelines.<\/jats:p><jats:p>RESULTS. Of 197 children, 70% were enrolled at the urban site, 18% at the suburban site, and 12% at the rural site. The average age was 7.9 years; 60% were male, and 33% were black. At presentation, nearly half (46%) of the children had mild intermittent asthma, 20% had mild persistent asthma, 15% had moderate persistent asthma, and 19% had severe persistent asthma. One quarter of the children had been hospitalized for asthma, and two thirds had at least 1 previous ED visit in the past year. At least 94% had health insurance coverage and 95% reported having a primary care provider.<\/jats:p><jats:p>Less than half of the children had attended at least 2 scheduled asthma appointments with their regular asthma care provider in the past year. Although only 5% of the subjects reported that the ED was their only source of asthma care, at least 30% reported that they always went directly to the ED when they needed urgent asthma care. Only 3 in 5 children possessed either a spacer or a peak-flow meter, whereas \u223c2 in 5 reported having a written asthma action plan. Among those with persistent asthma, there was considerable evidence of undertreatment, with 36% not on either an inhaled corticosteroid or a suitable long-term control medication. Only 20% completed a visit with their regular asthma care provider within 1 week of their ED visit.<\/jats:p><jats:p>CONCLUSIONS. Despite very high levels of health care coverage and access to primary care, the overall quality of asthma care and management fell well short of that recommended by national guidelines.<\/jats:p>","DOI":"10.1542\/peds.2005-2000i","type":"journal-article","created":{"date-parts":[[2017,1,26]],"date-time":"2017-01-26T18:31:21Z","timestamp":1485455481000},"page":"S118-S126","source":"Crossref","is-referenced-by-count":44,"title":["Asthma Care and Management Before an Emergency Department Visit in Children in Western Michigan: How Well Does Care Adhere to Guidelines?"],"prefix":"10.1542","volume":"117","author":[{"given":"Mathew J.","family":"Reeves","sequence":"first","affiliation":[{"name":"Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan R.","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Korzeniewski","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan"},{"name":"Grand Rapids Medical Education and Research Center\/Michigan State University Program in Emergency Medicine, Grand Rapids, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2006,4,1]]},"reference":[{"key":"2021120822354798200_R1","doi-asserted-by":"crossref","unstructured":"Zimmerman DR, Allegra JR, Cody RP. 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