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Asthma hospitalization rate per 10,000 adults age 65 and older

8.12015

Notes on Methodology

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, click here.

This indicator is age-adjusted to the 2000 U.S. standard population. In U.S. data, age adjustment is used for comparison of regions with varying age breakdowns. In order to remain consistent with the methods of comparison at a national level, some statistics in Vermont were age adjusted. In cases where age adjustment was noted as being part of the statistical analysis, the estimates were adjusted based on the proportional age breakdowns of the U.S. population in 2000. For more detailed information on age adjustment visit /www.cdc.gov/nchs/data/statnt/statnt20.pdf.

Story Behind the Curve

Last Updated: September 2018

Author: Asthma Program, Vermont Department of Health


The rate hospitalizations for asthma among Vermonters 65 years and older has been decreasing between 2005‐2015. In 2015, the VT rate was 7.8 per 10,000 and this was the first year when the rate was lower than the Healthy Vermonters target of 9.3 per 10,000. The VT rate of hospitalization for asthma among older adults is lower than U. S. rate. The most recent U. S. data available is from 2010 when the VT rate was 10.8 per 10,000 compared to the U.S. rate of 25.5 per 10,000.

Many factors are likely to contribute to this reduction in hospitalization rate and may include modifications to asthma medications and delivery technology, increased patient education, and increased promotion and usage of guidelines-based care for asthma.  Additional factors contributing to this decrease in asthma hospitalizations may the increased awareness of guideline based treatment, the efforts of Blueprint for Health in collaboration with practices and community health teams, and efforts to mitigate environmental triggers that can exacerbate asthma. Another reason for the general decrease over time could be from the myriad of other initiatives that hospitals and federal programs, including Centers for Medicare and Medicaid Services, are employing in an effort to reduce costs associated with hospitalization.

Strategy

A declining rate of hospitalizations may indicate that the Health Department’s Asthma Program’s focus on providing resources to improve Vermonter’s self-management is working to keep their asthma under control. 

The Vermont Asthma Program engages with lung health experts, partners, insurers, healthcare providers, hospitals, and schools to improve asthma control. Efforts focus on providing asthma self-management education in schools, clinics, and community settings, promoting use of Asthma Action Plans and proper use of spacers and inhalers, and assisting people to quit smoking and avoid tobacco smoke. Priorities include supporting in-home asthma education among populations with highest burden. The Asthma Program promotes other protective measures including receiving the annual flu shot, using clean burning stoves, and minimizing exposures to common triggers.

The Asthma Program is working with other New England state programs through the Asthma Regional Council to explore if there is a provider training program that all states could collaborate. Additionally, the Program organizes an Asthma Learning Collaborative each year to provide guideline care education for quality improvement practices in areas with higher hospitalization and/or emergency room visits due to asthma. The Vermont Asthma Program also works to disseminate Asthma Action Plans which are a validated tool for educating patients on how to manage asthma. The Program is in Year 4 of a M.A.P.L.E plan initiative in Rutland and Springfield aimed to help lower rates of hospitalization and readmission by forming plans for asthma management post hospital discharge. We will continue to support the Rutland Pediatric in home visiting program and will try to recreate a similar program in the Springfield area. The Easy Breathing initiative contributes to diagnosing asthma sooner. The Asthma Program also works with the Vermont Chronic Conditions Initiative (VCCI) to develop/educate their case managers with the goal that the case managers administer an asthma control test and demonstrate effective medication use. Lastly, the Asthma Program works with schools to train school nurses on asthma self-management and proper medication use so that school nurses can pass that knowledge onto those students who have missed school due to asthma.

What Works

In 2007, the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute (NHLBI), released its third set of clinical practice guidelines for asthma. The Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma (EPR-3) reflects the latest scientific advances in asthma drawn from a systematic review of the published medical literature by an NAEPP-convened expert panel. It describes a range of reviewed best-practice approaches for making clinical decisions about asthma care.

There are several strategies that work. Asking providers to implement the asthma clinical practice guidelines is shown to work. Other educators and clinicians, including certified asthma educators, delivering community education and school nurses providing self-management supports on how to manage and control asthma result in lower hospital readmissions. In most cases, people should not have to go to the hospital if they have properly controlled and managed asthma.

Why Is This Important?

In the United States in 2010, there were approximately 439,000 inpatient discharges with asthma as a primary diagnosis. These inpatient stays for asthma averaged 3.6 days in duration. Although inpatient hospitalization for asthma is less frequently used than outpatient and pharmaceutical services, its cost is substantially higher. As of 2010, an estimated 18.7 million adults, or 8.0% of the adult U.S population had asthma. In the U.S., there were 1.8 million total ED visits with asthma as primary diagnosis in 2011. 1

Hospitalizations due to asthma could be reduced if asthma is managed according to established guidelines. Effective management includes control of exposure to factors that trigger exacerbations, adequate pharmacological management, continual monitoring of the disease, and patient education in asthma care.2

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.


  1. CDC/National Center for Health Statistics. Last updated May, 2015. http://www.cdc.gov/nchs/fastats/asthma.htm
  2. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program, 2007.
Partners
  • Blueprint for Health is a partner that works with the Vermont Asthma Program on educating community health teams on asthma education and tools available to improve self-management, including Asthma Action Plans and Healthier Living Workshops that support improving asthma management.
  • Rutland Regional Medical Center is a partner that works with the Vermont Asthma Program on home visiting programs, the MAPLE hospital discharge protocol and community education.
  • Springfield Health Center is a partner that works with the Vermont Asthma Program on community education, clinical integration of asthma educators into practice, the MAPLE hospital discharge protocol and potential home visiting programs.
  • DVHA is a partner that works with the Vermont Asthma Program on reducing the burden of asthma among Medicaid-insured including exploring reimbursement for community-based education.
  • Vermont Department of Health Offices of Local Health are partners that work with the Vermont Asthma Program to disseminate asthma action plans and link local communities with primary care providers, community health teams and other resources.
  • Asthma Advisory Panel is a partner that works with the Vermont Asthma Program on developing strategic goals, disseminating data and evidence-based resources including Asthma Action Plans.
  • Northeast American Lung Association is a partner that works with the Vermont Asthma Program on supplying education materials to asthma educators within the state.
  • HMC Advertising is a partner that works with Vermont Asthma Program create a digital media plan with the goal of increasing awareness of asthma symptoms, triggers and referrals to 802Quits and tools like the Asthma Action Plan.
  • Vermont Chronic Care Initiative is a partner that will work with the asthma program on incorporating asthma education into their case management home visiting programs
Scorecard Result Program Indicator Performance Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy