• Michael D Cabana, David Bruckman, Susan L Bratton, Alex R Kemper, and Noreen M Clark.
• Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health Care System, Ann Arbor, Michigan 48109-0456, USA. mcabana@med.umich.edu
• J Asthma. 2003 Jan 1;40(7):741-9.

BackgroundThe National Heart, Lung, and Blood Institute (NHLBI) guidelines recommend that patients receive a follow-up outpatient asthma visit after being discharged from an emergency department (ED) for asthma.ObjectiveTo measure the frequency of follow-up outpatient asthma visits and its association with repeat ED asthma visit.DesignWe conducted a retrospective cohort study of children with asthma using claims data from a university-based managed care organization from January 1998 to October 2000. We performed a multivariate survival analysis using Cox proportional hazards model to determine the effect of follow-up outpatient asthma visits on the likelihood of a repeat ED asthma visit, after controlling for severity of illness, patient age, gender, insurance, and the specialty of the primary care provider.ResultsA total of 561 children had 780 ED asthma visits. Of these, 103 (17%) had a repeat ED asthma visit within 1 year. Almost two-thirds of children (66%) did not receive outpatient follow-up for asthma within 30 days of an ED asthma visit. Outpatient asthma visits within 30 days of an ED asthma visit are associated with an increased likelihood (relative risk = 1.80; 95% confidence interval 1.19, 2.72) for repeat ED asthma visits within 1 year.ConclusionsMost patients do not have outpatient follow-up after an ED asthma visit. However, those patients that present for outpatient follow-up have an increased likelihood for repeat ED asthma visits. For the primary care provider, these outpatient follow-up visits signal an increased risk that a patient will return to the ED for asthma and are a key opportunity to prevent future ED asthma visits.

19 keywords...

hide…