Last Updated: February 2023
Author: Asthma Program, Vermont Department of Health
In general, in Vermont there has been a general downward trend in the rate of hospitalizations for asthma among children under 4 years of age over the past decade. The rates of hospitalizations for children under four has decreased from a high of 20.2 in 2006 to an all‐time low of 8.6 per 10,000 in 2015. This meant the Vermont Asthma Program achieved the Healthy Vermonter 2020 target of 14% and had to lower the target by half to 7.0 in 2014 to provide a new target for further reduction in hospitalizations!
NOTE: Since the nearest hospital for many Vermont residents is out-of-state, the approach of the Vermont Asthma Program is to report full data including Vermont residents treated in adjacent states. Due to changes in data collection and processing technologies, updated data from NY and NH has been delayed and so the most recent data available for this indicator is from 2016. This indicator will be updated when more recent data is available.
Asthma hospitalizations have been declining over time with improved clinical care and patients following treatment guidelines. The decrease may be due to a program of comprehensive asthma control efforts being initiated in 2009 with support of a CDC grant. The Vermont Asthma Program began to expand efforts to promote national asthma best practices, including supporting regional hospitals with high asthma prevalence to provide home visiting for environmental trigger identification and elimination of those things that can exacerbate asthma and provide intensive asthma self-management education (AS-ME) to persistent uncontrolled or high-risk patients. These partners also worked to develop clinical protocols to improve asthma-related hospital discharge protocols to reduce readmissions. The second 5-year CDC grant cycle started in 2014 allowing spread to additional regional hospitals of best practices shown to work, with new elements focusing on a learning collaborative of health care providers implementing asthma best practices and monitoring outcomes in patient care.
Another reason for the general decrease over time could be from the myriad of initiatives hospitals and federal programs have been employing to reduce costs across the board. We also hear from clinical partners that diagnosing asthma in young children is difficult. Viral infections and other respiratory infections can mimic the asthma symptoms of wheezing and coughing. For this reason, it may be necessary to confirm a definite diagnosis of asthma after the child is older ﴾ 5 years old﴿.