Hospitalization due to asthma indicates poor asthma control that results in complication requiring inpatient care and potentially comorbid conditions. Based on the ICD-9 classification system, asthma hospitalization rate peaked in 2009, with an estimated age-adjusted rate of 14.6 per 10,000 population. For years 2009 and after, hospitalization rates are showing an overall decline, occurring in a sharper fashion among Black and Hispanics. However, the same groups are shown as the most affected ones with more than double the state hospitalization rate of 6.5 per 10,000 population for year 2019. The rates are lower in 2020 and 2021 due to the COVID-19 pandemic, but we are cautious of those rates and not making any conclusion before we have more normalzied data.

ICD-10 system was implemented in late 2015, and data from 2015 and earlier should not be compared to 2016 and later data. Hispanics and non-Hispanic Black individuals are affected more than 4-fold of non-Hispanic White. Children under 10 years of age are the most affected with a rate more than 2-fold of adults. Children of Hispanic origin or non-Hispanic Black are the subgroups most affected.

Prior target of 13.9 per 10,000 population in overall hospitalization rate was achieved, and a new target was set at 10.7 per 10,000 population for 2014. It should be noted that the Healthy People 2020 objective for asthma hospitalization rate is 8.7 for children and adults aged 5 to 64 years. Health People 2030 objective is still under development.

For years 2010 and after, total asthma hospitalization charges reached its acme in 2014, with about $95 million, with an average charge of $21,898 per hospitalization event. Year 2019 shows the highest average charge with $25,467 per hospitalization event, totaling about $56 million, the lowest total since 2010. The average hospitalization charge has increased by about 51% from 2010 to 2019.

{The burden of asthma varies within subgroups as multiple factors affect asthma control: urbanization, secondhand tobacco smoke, air pollution, psychological stress, obesity, inadequate asthma treatment and other risk factors. Barriers to adequate asthma management include economical and educational disadvantages, lack of health insurance, no access to or poor adherence with controller medications. (Rosser et al., Asthma in Hispanics: An 8-Year Update, American Journal of Respiratory Critical Care Medicine, Vol 189, No 11, pp.1316-1327, 2014.}

In partnership with the Connecticut Hospital Association in the late 2010's, strategies aimed at improving the follow-up care of patients discharged from the emergency rooms and hospitals has contributed to the decrease in hospitalization and emergency department visit rates.

Data Notes: Since October 1, 2015, all causes of hospitalization are classified according to the ICD-10-CM classification system.  The ICD-9-CM coding system was used for hospitalizations occurring before October 1, 2015.  The cause of hospitalization classifications before 2015 are not directly comparable to classifications for 2016 or later.  In addition, the classifications for calendar year 2015 are not directly comparable to either time periods because of the mix of codes used during this year.

These data are current as of February 2023. New data are expected by fall of 2023.

Potential Partners (SHIP):
Connecticut Department of Public Health; Connecticut Department of Social Services; Connecticut Department of Economic and Community Development; Connecticut Department of Energy and Environmental Protection; State Department of Education; Connecticut Department of Children and Families; State Legislature; local public health agencies; health care providers including pediatricians and thoracic specialists, community health centers, and hospitals; health professional associations; pharmacists and pharmaceutical companies; health insurers; American Lung Association and Thoracic Society; other organizations and coalitions focused on health and the environment; community service providers; philanthropic and research organizations that address asthma and respiratory diseases; schools of public health, allied health, nursing, and medicine.

Asthma Program:

Connecticut State Department of Education, Connecticut School Nurses Association, Connecticut Hospital Association, local public health departments, health professional associations, health care providers, community health centers, school-based health centers.

SHIP:

Implementation of the National Asthma Education Prevention Program guidelines. (National Asthma Education and Prevention Program Expert Panel Report 3 (NAEPP-EPR3), 2007. National Heart, Lung and Blood Institute, NIH.)

Asthma Program:

The NAEPP EPR-3 Guidelines strongly emphasizes the importance of:

• asthma assessment and management education to health providers
• ensuring communication and linkages between health providers
• the use of an asthma action plan
• the referral to a community partner

SHIP Strategies:

• Advocate for mandatory written asthma treatment plans for all children with asthma in schools and in licensed daycare centers, and for legislation to prohibit smoking in cars with children
• Promote the use of evidence-based asthma guidelines by primary care clinicians and dentists and other dental and medical professionals
• Conduct a public education campaign, in partnership with local television news stations, on the effects of poor air quality days on health
• Implement evidence-based, comprehensive asthma programs and smoking prevention and cessation programs
• Encourage pediatricians to discuss smoking cessation/prevention with parents
• Asthma Program will do ongoing program monitoring, conference calls to AIRS coordinators will focus on monitor activities and deliverables.

Asthma Program:

• Communicate and educate on the burden of asthma to multiple audiences and through different modalities
• Develop community outreach and education messages about ways to control asthma
• Promote, in partnership with the Connecticut Hospital Association, the continuum of asthma care of residents with asthma in the Community, by educating hospital providers and staff about best practice for asthma management and, by providing an Asthma Action Plan to all discharged patients
• Work with community partners, to implement home-based interventions to identify and remove environmental triggers and provide self-management education
• Improve asthma control among Connecticut Residents through community education and outreach
• Offer asthma education resources translated in Spanish