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Mitchell RJ, McMaugh A, Homaira N, Lystad RP, Badgery-Parker T, Cameron CM. The impact of childhood asthma on academic performance: A matched population-based cohort study. Clin Exp Allergy 2021; 52:286-296. [PMID: 34564913 DOI: 10.1111/cea.14022] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is inconclusive evidence of the effect of asthma on the academic performance of young people. This study aims to compare scholastic performance and high school completion of young people hospitalized with asthma compared to matched peers not hospitalized with asthma. METHOD A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalized for asthma during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalized linear mixed-modelling examined risk of school performance below the national minimum standard (NMS) and generalized linear regression examined risk of not completing high school for young people hospitalized with asthma compared to matched peers. RESULTS Young males hospitalized with asthma had a 13% and 15% higher risk of not achieving the NMS for numeracy (95%CI 1.04-1.22) and reading (95%CI 1.07-1.23), respectively, compared to peers. Young males hospitalized with asthma had a 51% (95%CI 1.22-1.86) higher risk of not completing year 10, and around a 20% higher risk of not completing year 11 (ARR: 1.25; 95%CI 1.15-1.36) or year 12 (ARR: 1.27; 95%CI 1.17-1.39) compared to peers. Young females hospitalized with asthma showed no difference in achieving numeracy or reading NMSs, but did have a 21% higher risk of not completing year 11 (95%CI 1.09-1.36) and a 33% higher risk of not completing year 12 (95%CI 1.19-1.49) compared to peers. CONCLUSIONS Educational attainment is worse for young people hospitalized with asthma compared to matched peers. Early intervention and strategies for better management of asthma symptoms may enhance academic performance for students.
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Affiliation(s)
- Rebecca J Mitchell
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Nusrat Homaira
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Reidar P Lystad
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tim Badgery-Parker
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Services District, Brisbane, Queensland, Australia.,Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
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Chan M, Gray M, Burns C, Owens L, Jaffe A, Homaira N. Assessment of Variation in Care Following Hospital Discharge for Children with Acute Asthma. J Asthma Allergy 2021; 14:797-808. [PMID: 34262298 PMCID: PMC8274827 DOI: 10.2147/jaa.s311721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/05/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose To evaluate potential variation in care management pathways following hospital discharge for children with asthma in New South Wales, Australia. Methods A cross-sectional web-based survey was conducted in emergency departments (EDs) and paediatric units of public hospitals with more than five paediatric beds within New South Wales, Australia, between July 2018 and March 2019. Nursing and medical staff in EDs and paediatric units who had cared for children aged under 18 years with asthma in the preceding 12 months were invited to participate in this study. Outcome measures included use of clinical practice guidelines and asthma action plan (AAP); advice on post-hospitalization follow-up; provision of asthma education for parents/carers; availability of community-based asthma services; communication with schools/childcare services. Results A total of 502 participants (236 nursing and 266 medical staff, response rate=22%) from 37 hospitals were included. Overall, the use of AAP was not universal (median=90%; IQR=81–96%) with significant difference across local health districts (LHDs) (88.6%, 95% CI=85.4–91.3) and between EDs and paediatric wards (p=9.4×10−9); and a range of asthma clinical practice guidelines were used. Post-hospitalization follow-up within 2–3 days was recommended by 70% of the respondents, but only 8% reported that hospitals had a system in place to ensure follow-up compliance. Formal asthma education sessions (27% respondents) were seldom provided to parents/carers during hospital stays, especially in EDs (14% respondents). Less than 50% of the respondents were aware of any asthma community services for children and only 4% reported that schools/childcare services were notified about the child’s hospital admission for an asthma flare up. Conclusion There are marked variations in the post-hospitalization asthma care and community management for children in NSW. An integrated standardized model of care may improve health outcomes in children with asthma.
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Affiliation(s)
- Mei Chan
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia
| | - Melinda Gray
- Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Christine Burns
- Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Louisa Owens
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Adam Jaffe
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Nusrat Homaira
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
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