Preventing Bounce-Backs: More Filled Meds, Less Hurting Heads

[摘要] We all want to reduce readmissions. Children hospitalized with asthma account for a significant proportion of hospitalizations and, thus, readmissions. Do our patients take their medications as often as we think? Do they even fill the prescriptions? By increasing prescription fill rate, can we reduce hospital readmissions?#### The studyThis retrospective cohort analysis of Medicaid claims data included >30 000 children from 12 states who were hospitalized for asthma from 2005 to 2007. The study linked hospitalization for asthma and readmission for asthma with β-agonist medication fill rate, oral steroid fill rate, and inhaled steroid fill rate. Readmission was defined as hospitalization with a primary or secondary diagnosis of asthma within 90 days of discharge. Prescription filling included pharmacy claims 1 day before discharge to 3 days after discharge. The authors hypothesized that filling of β-agonists and oral steroids would be associated with reduction in short-term readmission (≤14 days) and that filling inhaled steroids would reduce readmission at later intervals.#### The key findingsOf the >30 000 children hospitalized for asthma, 55% filled a prescribed β-agonist, 57% filled an oral steroid, and 37% filed an inhaled steroid. Readmission occurred for 1.3% of children by 14 days and 6.3% by 90 days. After adjusting for patient and billing factors, filled prescriptions for β-agonists (hazard ratio 0.67, 95% confidence ration …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob