Association between outpatient follow-up and pediatric emergency department asthma visits.


Journal Article

BACKGROUND:The 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. OBJECTIVE:To measure the frequency of follow-up outpatient asthma visits and its association with repeat ED asthma visit. DESIGN:We 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. RESULTS:A 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. CONCLUSIONS:Most 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.

Full Text

Cited Authors

  • Cabana, MD; Bruckman, D; Bratton, SL; Kemper, AR; Clark, NM

Published Date

  • January 2003

Published In

Volume / Issue

  • 40 / 7

Start / End Page

  • 741 - 749

PubMed ID

  • 14626330

Pubmed Central ID

  • 14626330

Electronic International Standard Serial Number (EISSN)

  • 1532-4303

International Standard Serial Number (ISSN)

  • 0277-0903

Digital Object Identifier (DOI)

  • 10.1081/jas-120023499


  • eng