TOP 38 - Understanding Disparities Related to Asthma Action Plan Creation for Patients Admitted to Pediatric Hospital Medicine: A Descriptive Analysis

Publication Number: 2789.TOP 38

Alexander R. Eaton, Boston Children's Hospital, Newton, MA, United States; Katherine V. Buchanan, Boston Children's Hospital, Boston, MA, United States; Maximilian Wengyn, Boston Children's Hospital, Boston, MA, United States; Julie R. Barzilay, Boston Children's Hospital, Brookline, MA, United States; Melissa Rubin, Boston Children's Hospital, Boston, MA, United States; Mercy Toma, Boston Children's Hospital, Boston, MA, United States; Katharine H. Nagle, Boston Children's Hospital, Wakefield, MA, United States; Daniel J. Kats, Boston Children's Hospital, Boston, MA, United States; Sarah McBride, Boston Children's Hospital, Boston, MA, United States; Lisa Rickey, Boston Children's Hospital, Boston, MA, United States; Katherine Pumphrey, Boston Children's Hospital, Boston, MA, United States

Background: Asthma is the most common chronic childhood disease in the United States and drives substantial health care utilization and family burden. Hospitalizations and ED visits are significant, and often preventable components of this burden. Although hospitalizations for asthma exacerbation have decreased over the last decade, disparities related to race and socioeconomic status have persisted. Furthermore, caregiver language preference has been shown to be associated with increased odds of asthma-related healthcare utilization. Comprehensive education prior to hospital discharge has been shown to decrease 3-month readmission rates for children hospitalized with an asthma exacerbation. Given this evidence, the Global Initiative for Asthma (GINA) 2025 Global Initiative for Asthma Management and Prevention recommends that all patients with asthma be provided with a written asthma action plan (AAP) as a key component of asthma self-management.

Objective: The primary aim of this study is to describe AAP completion at discharge for children admitted for asthma exacerbation stratified by well described disparities such as race, payor group, and preferred language. A secondary aim is to describe language concordant AAP completion at discharge. An exploratory aim is to examine re-visitation related to AAP completion.

Design/Methods: We conducted a retrospective chart review at our quaternary free-standing children’s hospital of patients aged 2-18 years old admitted for asthma exacerbation from 6/1/2024 and 8/16/2025 and discharged by Pediatric Hospital Medicine. 225 hospital encounters are included. Manual chart review identified (1) AAP creation and (2) language concordance. AAPs were considered "complete" if the electronic health record (EHR) indicated that the AAP had been printed prior to discharge. AAPs were considered language concordant if the preferred language recorded in the EHR aligned with language used in AAP. Additional data including age, sex, race, primary payor, and 7- and 30- day revisitation was obtained via the EHR. Revisitation was defined as ED visit or hospitalization at our hospital, or any record available on the Care Everywhere platform. This study was found to be exempt for human subject research by the hospital’s IRB. This description will inform a quality-improvement project to improve equitable AAP completion at discharge with the goal of reducing asthma exacerbation-related admissions.