ArticleThe Journal of allergy and clinical immunology2009
Quality of care for acute asthma in 63 US emergency departments.
Article in The Journal of allergy and clinical immunology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review.Frontiers in health services · 2026Pooled it
- Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians.Academic pediatricsTrial
- Impact of a standardized emergency department asthma care pathway on health services utilization.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025Article
- A Statewide Study of the Epidemiology of Emergency Medical Services' Management of Pediatric Asthma.Pediatric emergency care · 2021Observational
- Improving asthma care with Asthma-COPD Afterhours Respiratory Nurse at Emergency (A-CARE).BMJ open quality · 2020Article
- Improving Quality of Acute Asthma Care in US Hospitals: Changes Between 1999-2000 and 2012-2013.Chest · 2016Article
- Clinical pathway improves pediatrics asthma management in the emergency department and reduces admissions.The Journal of asthma : official journal of the Association for the Care of Asthma · 2015Article
- Defining emergency department asthma visits for public health surveillance, North Carolina, 2008-2009.Preventing chronic disease · 2014Article
- Quality improvement in pediatric inflammatory bowel disease: moving forward to improve outcomes.World journal of gastroenterology · 2013Review
- Childhood asthma hospitalizations in the United States, 2000-2009.The Journal of pediatrics · 2013Article
- Receipt of systemic corticosteroids during asthma visits to US emergency departments, 2007-2009.The Journal of asthma : official journal of the Association for the Care of Asthma · 2013Article
- Multicenter analysis of quality indicators for children treated in the emergency department for asthma.Pediatrics · 2012Article
- International society for disease surveillance conference 2011: building the future of public health surveillance.Emerging health threats journal · 2011Article
- A call for action: Comparative effectiveness research in asthma.The Journal of allergy and clinical immunology · 2011Review
- Can an evidence-based guideline reminder card improve asthma management in the emergency department?Respiratory medicine · 2010Article
- Risk stratification for hospitalization in acute asthma: the CHOP classification tree.The American journal of emergency medicine · 2010Article
- Salmeterol use and risk of hospitalization among emergency department patients with acute asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2010Article
- Quality of emergency care provided by physician assistants and nurse practitioners in acute asthma.The American journal of emergency medicine · 2010Article
- Advances in adult asthma diagnosis and treatment in 2009.The Journal of allergy and clinical immunology · 2010Review
- Factors associated with delayed use or nonuse of systemic corticosteroids in emergency department patients with acute asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2009Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundLittle is known about the quality of acute asthma care in the emergency department (ED).
objectivesWe sought to determine the concordance of ED management of acute asthma with National Institutes of Health asthma guidelines, to identify ED characteristics predictive of higher guideline concordance, and to assess whether guideline concordance was associated with hospital admission.
methodsWe conducted a retrospective chart review study of acute asthma as part of the National Emergency Department Safety Study. Using a principal diagnosis of asthma, we identified ED visits for acute asthma in 63 urban EDs in 23 US states between 2003 and 2006. Concordance with guideline recommendations was evaluated by using item-by-item quality measures and composite concordance scores both at the patient and ED level. These scores ranged from 0 to 100, with 100 indicating perfect concordance.
resultsThe cohort consisted of 4,053 subjects; their median age was 34 years, and 64% were women. The overall patient guideline concordance score was 67 (interquartile range, 63-83), and the ED concordance score was 71 (SD, 7). Multivariable analysis showed southern EDs were associated with lower ED concordance scores (beta-coefficient, -8.2; 95% CI, -13.8 to -2.7) compared with northeastern EDs. After adjustment for the severity on ED presentation, patients who received all recommended treatments had a 46% reduction in the risk of hospital admission compared with others.
conclusionsConcordance with treatment recommendations in the National Institutes of Health asthma guidelines was moderate. Significant variations in ED quality of asthma care were found, and geographic differences existed. Greater concordance with guideline-recommended treatments might reduce hospitalizations.
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Registered trials
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