Utilization of electronic portal referrals to a community agency for children presenting with an asthma exacerbation to a pediatric emergency department.

Purpose: To evaluate referral rates and factors associated with referrals to a community agency for children evaluated for an asthma exacerbation at a pediatric emergency department (PED) and compare PED visits for asthma the following year between those referred and not referred.

Methods: We reviewed electronic health records of children 2-18 years evaluated in our PED from 01/01/2019 to 12/31/2019 with an ICD-10 diagnostic code for asthma (J45x) following the introduction of a portal where clinicians could refer children to a community agency focused on improving health outcomes for asthma. We abstracted data on demographics, PED visits, and hospitalizations and used multivariate logistic regression to evaluate factors associated with referrals.

Results: Of the 2262 charts analyzed, the majority of patients were male (61%), Black (76%), and held public insurance (71%). Only a minority of patients ( = 140, 6%) were referred. Age [6-12 years (AOR: 1.93, 95% CI: 1.21-3.08,  = .006), 13-18 years (AOR: 10.61, 95% CI: 6.53-17.24,  = .001)] and lifetime number of PED asthma visits [≥3 visits (AOR: 1.91, 95% CI, 1.01-3.62,  = .05)] were associated with referral. There was no significant difference in the mean number of PED visits in one year [referred: 0.59 (1.2) not referred: 0.79 (1.3),  = 1.70,  = .09] between the two groups.

Conclusion: The referral rate to community agency from PED for asthma is low. There was no difference in short-term PED utilization for asthma between those referred and not referred.