Utilization of electronic portal referrals to a community agency for children presenting with an asthma exacerbation to a pediatric emergency department

Purpose: To evaluate referral rates and factors associated with referrals to a community agency for children evaluated for an asthma exacerbation at a pediatric emergency department (PED) and compare PED visits for asthma the following year between those referred and not referred. Methods: We reviewed electronic health records of children 2–18 years evaluated in our PED from 01/01/2019 to 12/31/2019 with an ICD-10 diagnostic code for asthma (J45x) following the introduction of a portal where clinicians could refer children to a community agency focused on improving health outcomes for asthma. We abstracted data on demographics, PED visits, and hospitalizations and used multivariate logistic regression to evaluate factors associated with referrals. Results: Of the 2262 charts analyzed, the majority of patients were male (61%), Black (76%), and held public insurance (71%). Only a minority of patients (n = 140, 6%) were referred. Age [6–12 years (AOR: 1.93, 95% CI: 1.21–3.08, p =.006), 13–18 years (AOR: 10.61, 95% CI: 6.53–17.24, p =.001)] and lifetime number of PED asthma visits [≥3 visits (AOR: 1.91, 95% CI, 1.01–3.62, p =.05)] were associated with referral. There was no significant difference in the mean number of PED visits in one year [referred: 0.59 (SD1.2) vs. not referred: 0.79 (SD1.3), t = 1.70, p =.09] between the two groups. Conclusion: The referral rate to community agency from PED for asthma is low. There was no difference in short-term PED utilization for asthma between those referred and not referred.