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Risk factors for return to the emergency department for asthma

Published online: April 28, 2018

A significant proportion of asthma patients return after being discharged from the emergency department (ED). Better understanding of the risk factors associated with ED return is important to prevent excessive acute care claims.

The purpose of this study, published in The Journal of Allergy and Clinical Immunology: In Practice by To et al., was to quantify the rate of ED return within 1-year of the intial visit and to determine factors associated with ED return for patients with asthma. This study examined return to the ED for asthma using health administrative records from a universal health care system in Ontario, Canada and included all individuals aged five to 99 with an initial ED visit during a six-year study period. A Poisson regression model was used to determine the risk of ED return after adjusting for other confounding factors.

One in eight individuals with a first asthma ED visit returned to the ED within a year. Younger age, lower socioeconomic status, and having chronic obstructive pulmonary disease were significantly associated with increased ED return risk. Over 80% of individuals did not have a follow-up visit with a general practitioner or respirologist within three days of their ED discharge.

The findings highlight the need for clinicians to encourage patients who visit the ED for asthma initially to attend a follow-up visit with their general practitioner. Health promotion interventions that seek to reduce acute care use or needs for asthma should target asthma patients at higher risk of ED return.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.