Weekend Versus Weekday Asthma-Related Emergency Department Utilization

Objective: To assess variation in asthma-related emergency department (ED) use between weekends and weekdays. Methods: Cross-sectional administrative claims-based analysis using California 2016 Medicaid data and Vermont 2016 and Massachusetts 2015 all-payer claims databases. We defined ED use as the rate of asthma-related ED visits per 100 child-years. A weekend visit was a visit on Saturday or Sunday, based on date of ED visit claim. We used negative binomial regression and robust standard errors to assess variation between weekend and weekday rates, overall and by age group. Results: We evaluated data from 398,537 patients with asthma. The asthma-related ED visit rate was slightly lower on weekends (weekend: 18.7 [95% confidence interval (CI): 18.3–19.0], weekday: 19.6 [95% CI, 19.3–19.8], P <.001). When stratifying by age group, 3- to 5-year-olds had higher rates of asthma-related ED visits on weekends than weekdays (weekend: 33.7 [95% CI, 32.6–34.7], weekday: 29.8 [95% CI, 29.1–30.5], P <.001) and 12- to 17-year-olds had lower rates of ED visits on weekends than weekdays (weekend: 13.0 [95% CI: 12.5–13.4], weekday: 16.3 [95% CI: 15.9–16.7], P <.001). In the other age groups (6–11, 18–21 years) there were not statistically significant differences between weekend and weekday rates (P >.05). Conclusions: In this multistate analysis of children with asthma, we found limited overall variation in pediatric asthma-related ED utilization on weekends versus weekdays. These findings suggest that increasing access options during the weekend may not necessarily decrease asthma-related ED use.