Teresa To1, Jingqin Zhu2, Kandace Ryckman3, Andrea Gershon4. 1. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: teresa.to@sickkids.ca. 2. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 3. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. 4. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Abstract
BACKGROUND: A substantial proportion of patients with asthma return after being discharged from the emergency department (ED). Given the high economic burden of acute care claims, and the impact on productivity and quality of life, a better understanding of risk factors for ED return is of interest. OBJECTIVE: To quantify the rate and determine factors associated with return to the ED for asthma within 1 year of an initial ED visit for asthma. METHODS: Individuals aged 5 to 99 years living in Ontario, Canada, with an ED visit for asthma in the period 2008 to 2014 were included. Descriptive statistics were used to compare those with an ED return with those without an ED return. An adjusted modified Poisson regression model was used to estimate the relative risk of ED return for asthma within 1 year after the initial discharge. RESULTS: In total, 58,366 individuals met the inclusion criteria. At 1-year follow-up, 12.1% returned to the ED at least once. Younger age, being materially deprived, and having chronic obstructive pulmonary disease were significantly associated with increased risk of ED return within 1 year after the initial visit. CONCLUSIONS: Nearly 1 in 8 individuals with a first ED visit for asthma returned to the ED within a year of the initial ED discharge. Targeting those at risk for ED return may help improve health care costs, productivity, and quality of life.
BACKGROUND: A substantial proportion of patients with asthma return after being discharged from the emergency department (ED). Given the high economic burden of acute care claims, and the impact on productivity and quality of life, a better understanding of risk factors for ED return is of interest. OBJECTIVE: To quantify the rate and determine factors associated with return to the ED for asthma within 1 year of an initial ED visit for asthma. METHODS: Individuals aged 5 to 99 years living in Ontario, Canada, with an ED visit for asthma in the period 2008 to 2014 were included. Descriptive statistics were used to compare those with an ED return with those without an ED return. An adjusted modified Poisson regression model was used to estimate the relative risk of ED return for asthma within 1 year after the initial discharge. RESULTS: In total, 58,366 individuals met the inclusion criteria. At 1-year follow-up, 12.1% returned to the ED at least once. Younger age, being materially deprived, and having chronic obstructive pulmonary disease were significantly associated with increased risk of ED return within 1 year after the initial visit. CONCLUSIONS: Nearly 1 in 8 individuals with a first ED visit for asthma returned to the ED within a year of the initial ED discharge. Targeting those at risk for ED return may help improve health care costs, productivity, and quality of life.