Identifying Children with Persistent Asthma from Health Care Administrative Records

BACKGROUND: Investigation into the origins of asthma is contingent on definitions of asthma, which can differentiate asthma from transient wheezing syndromes in children.OBJECTIVES: This research was undertaken to develop a definition for asthma derived from health care administrative records, which would identify children with persistent asthma.PATIENTS AND METHODS: Using population-based, healthcare administrative data, children with possible asthma were identifiedas having one or more physician visits or hospitalizations forasthma or bronchitis diagnoses from January 1995 to December 1995,or, in the absence of asthma-like diagnoses, one or more prescriptionsfor asthma prophylaxis drugs or ketotifen concomitant with a betaagonist,or two or more prescriptions for beta-agonists.RESULTS: The likelihood of persistent asthma, defined as repeatedhealth care and prescription use for asthma from 1996 to 1998, wasassessed for various asthma markers and risk factors in 29,198 childrenwith possible asthma. Children with asthma prescription drugsor asthma health care use not limited to the winter season werethree to six times more likely than children without these characteristicsto have persistent asthma. The likelihood of persistent asthmawas elevated to a substantial degree in the presence of both of thesemarkers.CONCLUSIONS:The inclusion of these measures in a diagnosisbased definition improves the ability to identify persistent asthma in children.Peer Reviewe