Emergency room use for asthma highly prevalent in children

Although poor asthma control is multifactorial, there is no doubt that timely access to outpatient specialty asthma care can prevent exacerbations that result in frequent emergency room visits.  Dr. Susarla

Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease.

Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the latest available rates by county.

In Los Angeles County, ER visit rates rose by 17 percent for children 5 and older and by 8 percent for children under 5. 

In some parts of the state, especially the Central Valley, the increases were far higher. The rate of emergency room visits for children 5 and older more than doubled in rural Madera County and nearly doubled in Merced. 

All told, more than 72,000 California children under 18 visited the ER for asthma in 2012, nearly 21,000 of them from Los Angeles County.

“There’s clearly more work to be done if this many kids are going to the emergency department,” said Anne Kelsey Lamb, director of the Regional Asthma Management and Prevention program of the Oakland-based Public Health Institute. “We know a lot about what works. We absolutely should be able to reduce the rates we’re seeing.”

At the national level, asthma-related emergency room visit rates have declined in recent years, according to federal health data through 2010, the latest available.

Although ER visits declined in some counties, including Alameda, San Mateo and Marin, the overall rise in California has frustrated public health experts who have spent millions of dollars and countless hours to improve and expand asthma prevention programs around the state. The state and federal governments alone spend $1.54 million annually on such projects in California, including grants to schools to improve indoor air quality and training community health workers.

The reasons for the increase in ER visits are complex, experts say. They include parents not properly administering medications, poverty and inadequate insurance coverage, persistently high levels of indoor and outdoor pollution in some regions and the limited reach of programs that seek to manage symptoms or prevent them.

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