Risk Factors Associated with Pediatric Asthma Revisits to Emergency Departments

Background : Asthma is one of the most common reasons for emergency department (ED) visits among children in the United States. Although prior studies have found sociodemographic disparities in asthma revisit, most focus on short follow-up periods or single-state data, limiting understanding of persistent ED reliance over time. The purpose of this study was to fill this gap and understand associations between sociodemographic characteristics and the likelihood of ED revisits. Methods : This observational retrospective cohort study used ED data for 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 ED usage across time. Logistic regression was used to identify ED revisit predictors for the 2016 asthma cohort. Results : Among 38,331 children with an asthma-related ED visit in 2016, 32 percent of the 2016 cohort returned to the ED 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, were associated with higher odds of revisits for asthma. Other factors contributing to higher odds of asthma ED revisits included being male, having Medicaid insurance, living in lower-income neighborhoods, and living in large metro areas. Conclusions : There are persistent sociodemographic and geographic disparities in asthma ED readmissions.