Background: Asthma is the most common chronic disease of childhood. Preventative outpatient asthma care improves patient outcomes. The use of Urgent Care Centers (UCC) has grown. Asthma outcomes related to UCC use are unknown. Purpose: To evaluate outcomes of children with asthma receiving care at UCCs as compared to traditional outpatient care, including rates of hospitalizations, preventative medication and oral steroid prescriptions; and hospitalization and primary care follow-up after UCC care. Methods: Using the Military Health System (MHS) database children ages 2-18 years with asthma cared for in Maryland, the District of Columbia and Virginia in 2009-2015 were identified. Asthma was identified by International Classification of Disease-9th Edition (ICD-9) codes. UCC providers were identified in National Provider Identifier (NPI) registries. Children who used UCCs were categorized into quartiles by percent of all asthma care received at UCCs, and compared to children who received 100% of asthma care at traditional outpatient care centers. Oral steroid and preventative medication prescriptions were identified by name in outpatient pharmaceutical records using National Asthma Education and Prevention Program medication guidelines. ICD-9 codes identified asthma hospitalizations and outpatient follow-up. Negative binomial regression analysis determined the incidence rate ratio (IRR) for prescriptions and hospitalizations by care received at UCCs. Logistic regression analysis determined the impact of UCC care on receipt of primary care follow up within 14 days and acute hospitalization within 30 days. All models controlled for number of providers. Results: 49,928 included children, median age 9 [IQR 5-14], had diagnosed asthma. 9% received part of their primary/asthma related care at UCCs. 63.5% were prescribed oral steroids and 96.2% were prescribed controller medications, and had 11,754 asthma related hospitalizations during the study period. Patients using UCCs had higher rates of oral steroid and preventative medication prescriptions, as compared to those who did not use UCCs. The rate of hospitalization increased with higher UCC use (Table 1). UCC acute asthma care was associated with increased odds of asthma hospitalization within 30 days (OR 1.43 [1.03-199]), but not with follow-up care within 14 days (OR 0.90 [0.76-1.06]). Conclusion: Receipt of asthma care at UCCs is related to increased asthma related hospitalizations, oral steroid and preventative medication prescriptions. UCCs may result in inconsistent care leading to less effective asthma management.

Table 1

Asthma prescriptions and hospitalizations by Urgent Care Center use

Table 1

Asthma prescriptions and hospitalizations by Urgent Care Center use

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