To identify factors associated with severe asthma exacerbations in children as measured by the number of emergency department (ED) visits and hospitalizations.

Asthmatic children aged 1 to 18 years were enrolled from specialty and family practice hospital-based outpatient clinics and 2 EDs in Ontario, Canada, from November, 1, 2000, through March 31, 2003.

Data regarding demographics, socioeconomic status, drug plan characteristics, health status, health utilization, and symptom data were collected during this retrospective cohort study. These data were compared with data on asthma ED visits and hospitalizations in the full group and a subgroup with prescription drug coverage.

Complete data were available from 490 patients. Fewer exacerbations were associated with medium/high income, older children, recruitment from a physician's office or asthma clinic, and having an action plan. Previous ED visits, pet ownership, nebulizer use, asthma education, and younger age were associated with more exacerbations. A history of food, medication, and...

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