DefinitionHospitalizations or emergency department (ED) visits with a primary diagnosis of asthma.
*ICD-9-CM code: 493 (2000 through 2015)
*ICD-10-CM code: J45 (2016 and onward)
NumeratorNumber of hospitalizations or ED visits due to asthma occurring among residents of a geographic area in a time period.
DenominatorFor rates, estimated population of a geographic area in a time period using mid-year population estimates.
Data Interpretation Issues'''Overall Discharge Volume in 2020: '''
Hospital claim volume for the 2020 calendar year was markedly lower (19.9%) than for 2019, mostly due to the COVID-19 pandemic. This reduction was seen in both inpatient discharges (8.2% lower claim volume than 2019) and emergency department visits (27.3% lower claim volume than 2019). This was likely the result of hospital care being redirected to address the care for COVID-19 patients while elective surgeries and other outpatient care services were being postponed.
'''ICD Coding between 2015 and 2016: '''
The nationwide switch from ICD-9-CM to ICD-10-CM hospital diagnosis coding on October 1, 2015 disrupted trends for some diseases and conditions. Asthma is one of those. Please interpret trend data in this report with caution. Also note that New Jersey's data for October through December, 2015 was recoded to ICD-9-CM so that entire year of data was coded the same way.
Why Is This Important?Asthma is a chronic disease that affects the airways that carry oxygen in and out of the lungs. Asthma cannot be cured, but it can be controlled with an effective medical management plan and avoidance of environmental or occupational triggers.
Healthy People Objective: Reduce hospitalizations for asthmaU.S. Target: a. children under 5 years of age: 18.2,
b. persons aged 5 to 64 years: 8.7 (age-adjusted),
c. persons aged 65 years and older: 20.1 (age-adjusted)
Other Objectives'''Revised Healthy New Jersey 2020 Objective AS-2''': Reduce the crude hospitalization rate due to asthma per 100,000 age-specific population: [[br]]
a. children aged under 5 years: 221 for all races/ethnicities, 129 among Whites, 527 among Blacks, 219 among Hispanics, and 77 among Asians.[[br]]
b. persons aged 5 to 64 years: 67 for all races/ethnicities, 39 among Whites, 181 among Blacks, 72 among Hispanics, and 12 among Asians.[[br]]
c. persons aged 65 years and older: 73 for all races/ethnicities, 51 among Whites, 136 among Blacks, 147 among Hispanics, and 50 among Asians.
'''Revised Healthy New Jersey 2020 Objective AS-3''': Reduce the crude rate of emergency department (ED) visits due to asthma per 100,000 age-specific population: [[br]]
a. children aged under 5 years: 1,103 for all races/ethnicities, 556 among Whites, 3,089 among Blacks, 1,175 among Hispanics, and 247 among Asians.[[br]]
b. persons aged 5 to 64 years: 533 for all races/ethnicities, 267 among Whites, 1,663 among Blacks, 588 among Hispanics, and 64 among Asians.[[br]]
c. persons aged 65 years and older: 151 for all races/ethnicities, 78 among Whites, 483 among Blacks, 332 among Hispanics, and 60 among Asians.[[br]]
How Are We Doing?In New Jersey, over 600,000 adults (9.0%) and 167,000 children (8.7%) are estimated to have asthma currently. The number of women with asthma is almost double the number of men with asthma; however, asthma occurs more frequently in boys than girls. Anyone can develop asthma; however, children, Black, Hispanic, and urban residents are most likely to be affected. Individuals with allergies and people with a family history of asthma are also most likely to suffer from this disease.
Hospitalization rates for asthma do not represent the total burden of the illness. Most asthma attacks are successfully managed without hospitalization. Many people with asthma prevent serious asthma attacks through avoidance of triggers and effective medical management. In addition, many people with asthma episodes are treated in emergency departments and are not included in hospitalization statistics. Hospitalization rates measure an infrequent, severe outcome of this disease.
Asthma inpatient hospitalization and emergency department (ED) visit rates vary widely among New Jersey counties. Rates for emergency visits are highest in Cumberland, Essex, and Camden Counties, and lowest in Somerset, Morris and Hunterdon Counties. Disparities in inpatient hospitalization and emergency department visit rates likely reflect differences in: access to effective medical management; co-existing chronic diseases; and environmental or occupational asthma triggers.
The Healthy New Jersey 2020 targets for hospitalizations and ED visits were revised due to the change in medical record coding to ICD-10-CM.
Hospital claim volume for the 2020 calendar year was markedly lower than for 2019, mostly due to the COVID-19 pandemic.
What Is Being Done?The NJ Department of Health's [http://nj.gov/health/fhs/chronic/asthma/ Asthma Awareness and Education Program] (AAEP) provides information on asthma for consumers and health professionals.
The NJ Department of Health's Occupational Health Service has a [http://www.state.nj.us/health/eoh/survweb/wra/index.shtml Work-Related Asthma Program] that provides information to workers and employers about prevention of asthma in the workplace.
State law (Statute Amendment 18A:40-12.3) requires school districts to allow students to carry and administer their own asthma medication. The law further requires both public and non-public schools to provide and maintain at least one nebulizer for students with asthma.