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Pediatric asthma revisits to the ED and the role of primary care physicians versus asthma specialists
J ALLERGY CLIN IMMUNOL VOLUME 113, NUMBER 2
Pediatric Asthma Revisits to the ED and the Role of Primary Care Physicians Versus Asthma Specialists
A. Lateef, S. J. McGeady, E. Yousef; Allergy and Immunology, Thomas Jefferson University, Philadelphia, PA. RATIONALE: Stressful and costly revisits to an emergency department (ED) for asthma exacerbation occur often. This study examines the frequency with which asthmatic children require multiple ED visits and explores the effect of age and specialty care on this phenomenon. METHODS: We conducted a systematic chart review of all pediatric patients treated for asthma in the ED of the AI duPont Hospital for Children between 1/1/00 to 3/1/03. RESULTS: There were 3565 ED encounters for asthma involving 2603 children. In 602/2603 (23%) there were multiple visits with 388/2603 (14.9%) having one revisit and 214/2603 (8.2%) >1 revisit; 83/2603 (3.2%) had revisits within 5 days of the first visit and 149/2603 (5.7%) within 30 days. Mean age increased significantly with number of revisits (p<0.05) possibly showing progression from transient wheezing to true bronchial asthma. Of the 602 patients with multiple visits to the ED, 199 (33%) were managed by an asthma specialist (12% by allergists and 21% by pulmonologists) and 403/602 (67%) were managed by a primary care physician. CONCLUSIONS: We conclude that: 1. Repeat ED visits are commonplace for asthmatic children. 2. The number of revisits is a function of the age of the patient. 3. Almost 6% of patients had revisits in close proximity to initial contact which may reflect insufficient initial treatment or inadequate follow-up. 4. Consistent with earlier studies, asthma patients managed by specialists, particularly allergists, may fare better as judged by frequency of ED revisits. Funding: Self-funded
MONDAY
911
Abstracts S253
Pediatric Asthma Revisits to the ED and the Role of Primary Care Physicians Versus Asthma Specialists
A. Lateef, S. J. McGeady, E. Yousef; Allergy and Immunology, Thomas Jefferson University, Philadelphia, PA. RATIONALE: Stressful and costly revisits to an emergency department (ED) for asthma exacerbation occur often. This study examines the frequency with which asthmatic children require multiple ED visits and explores the effect of age and specialty care on this phenomenon. METHODS: We conducted a systematic chart review of all pediatric patients treated for asthma in the ED of the AI duPont Hospital for Children between 1/1/00 to 3/1/03. RESULTS: There were 3565 ED encounters for asthma involving 2603 children. In 602/2603 (23%) there were multiple visits with 388/2603 (14.9%) having one revisit and 214/2603 (8.2%) >1 revisit; 83/2603 (3.2%) had revisits within 5 days of the first visit and 149/2603 (5.7%) within 30 days. Mean age increased significantly with number of revisits (p<0.05) possibly showing progression from transient wheezing to true bronchial asthma. Of the 602 patients with multiple visits to the ED, 199 (33%) were managed by an asthma specialist (12% by allergists and 21% by pulmonologists) and 403/602 (67%) were managed by a primary care physician. CONCLUSIONS: We conclude that: 1. Repeat ED visits are commonplace for asthmatic children. 2. The number of revisits is a function of the age of the patient. 3. Almost 6% of patients had revisits in close proximity to initial contact which may reflect insufficient initial treatment or inadequate follow-up. 4. Consistent with earlier studies, asthma patients managed by specialists, particularly allergists, may fare better as judged by frequency of ED revisits. Funding: Self-funded
MONDAY
911
Abstracts S253