Exploring gaps and opportunities in primary care following an asthma hospital admission: a multisite mixed-methods...

Area of Science:

• Pediatric Healthcare
• Primary Care Medicine
• Respiratory Medicine

Background:

• Asthma is a common childhood illness requiring hospital admission.
• Effective primary care follow-up is essential for managing pediatric asthma and preventing readmissions.
• Gaps exist in the coordination between hospital care and primary care for children with asthma.

Purpose of the Study:

• To identify gaps and opportunities in primary care for children after hospital admission for asthma.
• To explore the patterns of primary care utilization and general practitioner (GP) involvement in pediatric asthma management post-hospitalization.

Main Methods:

• Exploratory mixed-methods study utilizing linked hospital and primary care administrative data.
• Involved 767 caregivers, 39 caregiver interviews, and surveys from 277 general practitioners (GPs) for children aged 3-18 years admitted for asthma in Victoria, Australia (2017-2018).

Main Results:

• Most caregivers reported a regular GP, but few children attended a GP within 24 hours before or 7 days after hospital admission for asthma.
• Children readmitted for asthma were less likely to have visited a GP in the non-acute phase and their GPs were more often unaware of the hospital admission.
• Fewer GPs felt confident managing poorly controlled or post-discharge pediatric asthma compared to well-controlled asthma.

Conclusions:

• While causality is unproven due to study design, findings highlight suboptimal primary care engagement post-hospitalization for pediatric asthma.
• There is a need to enhance preventative primary care visits and improve communication between hospitals and GPs.
• Guideline-concordant care by GPs is essential for optimizing outcomes in children with asthma.