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Follow-Up After Asthma Emergency Department Visits and Its Relationship With Subsequent Asthma-Related Utilization
Naomi S Bardach1, Valerie S Harder2, Charles E McCulloch3
1Department of Pediatrics (NS Bardach), University of California, San Francisco, Calif; Philip R. Lee Institute for Health Policy Studies (NS Bardach and R Thombley), University of California, San Francisco, Calif.
Academic Pediatrics
|March 27, 2022
Summary
Follow-up care after an asthma emergency department visit significantly reduces subsequent emergency visits. Improving this follow-up rate presents a key opportunity to enhance asthma management and patient outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Health
- Healthcare Management
Background:
- Asthma is a leading cause of emergency department (ED) visits among children and adolescents.
- Suboptimal follow-up care after ED visits may contribute to recurrent asthma exacerbations and healthcare utilization.
Purpose of the Study:
- To evaluate the association between timely outpatient follow-up and subsequent asthma-related ED utilization in pediatric patients.
- To identify the rate of 14-day follow-up after an asthma-related ED visit and its impact on future ED revisits.
Main Methods:
- Retrospective analysis of claims data from California, Vermont, and Massachusetts (2013-2016) for patients aged 3-21 with asthma-related ED visits.
- Follow-up defined as a visit with a primary care provider or asthma specialist within 14 days of the index ED visit.
- Logistic regression and mixed-effects negative binomial regression models were used to assess the relationship between 14-day follow-up and subsequent ED revisits at 60 and 365 days.
Main Results:
- Out of 90,267 asthma-related ED visits, only 22.6% had 14-day follow-up.
- Patients with follow-up were younger and had more complex health conditions.
- 14-day follow-up was significantly associated with decreased asthma-related ED revisits at 60 days (5.7% vs. 6.4%) and 365 days (25.0% vs. 28.3%).
- The rate of repeated subsequent ED revisits was also lower in patients with timely follow-up (66.7 vs. 77.3 revisits/100 child-years).
Conclusions:
- Timely outpatient follow-up after an asthma-related ED visit demonstrates a protective association against subsequent ED revisits.
- This finding suggests improved asthma control, potentially due to adherence to clinical guidelines.
- Enhancing the rate of 14-day follow-up care represents a critical opportunity to improve asthma management and reduce healthcare costs.
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