Risk Factors Associated With Pediatric Asthma Revisits to Emergency Departments.

Introduction: Asthma is one of the most common reasons for emergency department visits among children in the U.S. Although prior studies have found sociodemographic disparities in asthma revisits, most focus on short follow-up periods or single-state data, limiting the understanding of persistent emergency department reliance over time. The purpose of this study was to fill this gap and understand the associations between sociodemographic characteristics and the likelihood of emergency department revisits. Methods: This observational retrospective cohort study used emergency department data from the states of Florida, Maryland, and Wisconsin for the years 2016-2019. The study identified a sample of children aged 0-17 years with asthma visits in 2016 and observed their asthma emergency department usage over time. Logistic regression was used to identify predictors of emergency department revisits for the 2016 asthma cohort. Results: Among 38,331 children with an asthma-related emergency department visit in 2016, 32% of the 2016 cohort returned to the emergency department for additional asthma visits between 2017 and 2019, with most revisits occurring in 2017. In adjusted analyses, Black and Hispanic children as well as younger children, particularly those aged 5-11 years, had higher odds of revisits for asthma. Other factors that contributed to higher odds of asthma emergency department revisits included being male, having Medicaid insurance, living in lower-income neighborhoods, and living in large metropolitan areas. Conclusions: Persistent sociodemographic and geographic disparities exist in asthma emergency department readmissions.