MHA Professor and Student Publish Critical Research Exploring Childhood Asthma

Dr. Pavani Rangachari, professor and director of the University’s MHA program, and I recently worked together to publish an article in the International Journal of Environmental Research and Public Health (IJERPH). The article was based on a collaborative study with an academic medical center and entailed the collection of primary data through chart review by medical students.

The study examined individual risk factors associated with unscheduled healthcare use (ED visits or hospitalizations) for childhood asthma at the academic medical center. The rationale behind our interest was that unscheduled healthcare use for childhood asthma could be the result of individual demographic factors (e.g., patient’s age or asthma severity), or healthcare system factors (e.g., quality of provider-patient communication on asthma management or “supported self-management”) or even social or community-based risk factors, (e.g., absence of caregiver support or adverse social determinants of health impacting access to outpatient care for asthma).

The study found that while individual demographics, such as asthma severity and age, were significant in predicting unscheduled healthcare use, they only partially explained unscheduled healthcare use, since there were users and non-users of unscheduled healthcare across all severity levels (lowest to highest) for childhood asthma. This suggests considerable room for reducing unscheduled healthcare use through proactive interventions to improve “supported self-management of asthma” at the provider and organizational levels.

‘The findings help identify short- and long-term strategies’

Importantly, clinic no-shows (missed outpatient visits for asthma) also emerged as a significant predictor of unscheduled healthcare use, and since clinic no-shows could be viewed as both an individual behavioral risk factor and a social risk factor (e.g., absence of caregiver support could lead to missed clinic visits), the study also helped provide insights into the role of adverse social determinants impacting unscheduled healthcare use.

Overall, the findings helped to identify short- and long-term strategies for improving supported self-management and reducing unscheduled healthcare use for childhood asthma at the patient, provider, and organizational levels.

Dr. Rangachari recently also published another article in an international peer-reviewed journal, BMC Health Services Research. This article addresses the topic of “telehealth implementation” through a scoping review of the literature to understand what has been learned from “applications of the Consolidated Framework of Implementation Research (CFIR) to telehealth implementation initiatives.”

I have greatly enjoyed working with Dr. Rangachari and pursuing research I am passionate about.

Dr. Niharika Pathak ’23 MHA, a dentist, is a candidate in the University’s Master of Healthcare Administration program.