Improving Asthma Outcomes in Children: From the Emergency Department and Into the Community

Asthma is responsible for significant disease burden and health care cost. A heterogeneous disease with significant environmental, genetic, and economic risk factors, asthma disproportionally affects the most vulnerable children. Effective strategies to improve individual asthma control rely on a multidisciplinary, cross-sector approach. The emergency department (ED) is a critical resource to identify children at risk for high morbidity and mortality from asthma. It is imperative to identify barriers to asthma control in the ED while being mindful of transitions and care coordination, especially as the United States moves to value-based reimbursement of health care. We review recent literature on ED-based interventions, present data on the importance of addressing housing and involving schools, and conceptualize an ideal medical home for asthma. We also provide examples of how our own institution has developed programs across sectors to improve asthma outcomes in children.