Out-of-hours attendance and outcomes for asthmatic patients at two primary care services

To describe patients who choose different primary care services for asthma care at Wellington general practitioner run After-hours Medical Centre (AMC) and Wellington hospital emergency department (WED).

Two month prospective study of patients attending out-of-hours.

Eighteen percent of 249 AMC patients and 47% of 126 WED patients had a community services card and 6% and 7% respectively had high user health cards (p < 0.0001). AMC patients were more likely to:- be younger (mean age 19.3 vs 24.9 years, p < 0.006), live further from the service mean distance 5.3 km vs 4.1 km, p < 0.003), be given a repeat prescription for asthma medication (20% vs 3%, p < 0.0001), and be sent back to their GP (67% vs 25%, p < 0.0001). AMC patients were less likely to be referred by a GP (4% vs 9%, p < 0.05) and be admitted (1% vs 30%, p < 0.0001). 22.5% of patients admitted for asthma had seen a general practitioner prior to admission.

Asthmatic patients had different outcomes at the two services which reflects different management policies at the two services. More research is needed on access factors influencing attendance for asthma such as the direct cost to the patient, the distance services are located from patients homes, and the time when services are convenient for patients.