Health Assessment Record: Beginning with the 2003/2004 school year, legislation required that the school Health Assessment Record (HAR) contain a chronic disease assessment including asthma. Each year, school nurses report the age, gender, and race/ethnicity of students in their school who have an asthma diagnosis recorded on the HAR. The law mandates only the reporting of students with a diagnosis of asthma indicated on the HAR, and nurses have repeatedly reported that this results in a drastic underestimate of the number of students with asthma. Another limitation is that there is no standardized software package for school nurses; it is not currently possible to automate the collection of health data from the school HAR. Hence, most school nurses manually review student's HAR’s and report in a paper format to DPH
The HAR Asthma Database is only one part of the CT DPH asthma surveillance system. Five other data sources have been used for routine surveillance over the past 4 years. Prevalence estimates for adults and children in the general population have been obtained from the Behavioral Risk Factor Surveillance System adult and child asthma modules. Medicaid data has been used to examine the prevalence and health care usage for asthma among children enrolled in HUSKY A. Information on hospitalizations and ED visits for asthma is obtained from CHIME, Inc.; data include information on encounters with a primary or secondary diagnosis of asthma. Data on deaths with asthma identified as a primary or underlying cause are received from the DPH Office of Vital Records. The Asthma Program also received information on individuals who are diagnosed with work related asthma from the Occupational Disease Surveillance System housed with the DPH Occupational Health Program.
The Asthma Program, along with other programs within the Department, have experienced difficulties over the past years in getting access to updated hospitalization and ED data that contains identifiers. This lack of current information has hindered surveillance efforts at the state and the community level.