Creation and validation of a citywide pediatric asthma registry for the District of Columbia

Abstract

Objective

To create and validate a citywide pediatric Asthma Registry to improve the care and outcomes of children and adolescents in Washington, DC through data-driven quality improvement (QI).

Methods

All available electronic health record data from inpatient and outpatient domains of Children’s National Hospital were aggregated from an existing enterprise data warehouse. Inclusion criteria included asthma relevant ICD-10 codes over the prior 24 months. Available Asthma Registry measures include patient demographics, ambulatory visits, hospital admissions, persistent asthma diagnoses, and prescription of controller medications. Data capture was validated using US Census data and current asthma prevalence estimate of the Behavioral Risk Factor Surveillance System (BRFSS).

Results

The registry identified 15,991 DC children and adolescents with asthma aged 0–17 years, inclusive, at the end of 2020. This was 14.2% higher than the estimate of 14,001 children derived from BRFSS. Characteristics of those in the registry included: mean age of 9.5 (1.4) years, 57.9% male, 72.3% Black, and 66.7% publicly insured. Over the prior 24 months, 30.3% had ≥1 emergency department visit, and 10.5% had ≥1 hospital admission. Controller medications were prescribed for 59.6% of children with persistent asthma. Rates varied by sampled primary care practice sites.

Conclusions

A population-level pediatric asthma registry captures more children and adolescents with asthma in DC then a BRFSS-derived estimate, and provides city-wide measures of asthma-related utilization. The registry allows for stratification by primary care practice locations and asthma characteristics, supporting the design, implementation, and evaluation of QI projects at the practice, health system, and population levels.

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Keywords:

• population health
• disease registry
• pediatric asthma
• quality improvement

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Stephen Teach reports funding from the NIH/NIAID, NIH/NICHD, NIH/NHLBI, and EJF Philanthropies, and royalties from UpToDate; these do not present a conflict of interest for this work.

Additional information

Funding

This work was supported by a grant from DC Health (#CHA2017-000024) and by EJF Philanthropies.

Funding

This work was supported by a grant from DC Health (#CHA2017-000024) and by EJF Philanthropies.