Acute asthma attacks are frequent causes of Emergency Department (ED) visits. This study characterize patients who repeatedly visited ED and to assist the targeting of appropriate future intervention in order to reduce avoidable ED attendance.

All children with asthma who were seen during January 2001 to December 2001 in ED of Medical Center of Louisiana (MCLNO) in New Orleans. All of the information was based on retrospective patient chart reviews and parameters included demographic, insurance status, ED visits and treatment.

During 2001, 572 children were treated for asthma. The majority of the patients (97%) were African-American. Half of the patients came from single parent families. Forty-four percent were exposed to environmental tobacco smoke. Eighty-four percent of the patients were from inner city zip codes. Fifty-six percent of these patients were covered by medical insurance and the remaining 44% were uninsured. About 60% of the patients visited the ER 1 to 4 times, 30% 5 to 9 times, 7% 10 to 14 times and 3% 15 to 19 times. Twenty-four percent of these patients reported using inhaled corticosteroids. Three percent of the patients used leukotriene antagonists while 10% used cromolyn. More than half of the patients (63%) just relied on B2-agonists.

We conclude that low-socio-economic class, urbanicity, environmental factors and a marked underuse of anti-inflammatory drugs are important risk factors for repeated ED attendance. There is a need to institute aggressive interventions to improve the quality of care and prevent costly ED visits.