Predictors of Primary Care Follow-Up After a Pediatric Emergency Visit for Asthma |
| |
Authors: | Joseph J Zorc Richard J Scarfone Yuelin Li |
| |
Institution: | 1. Divisions of Pediatric Emergency Medicine, Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PennsylvaniaUSAzorc@email.chop.edu;3. Divisions of Pediatric Emergency Medicine, Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PennsylvaniaUSA;4. Center for Outcomes Research, Department of Anesthesia, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PennsylvaniaUSA |
| |
Abstract: | Objective. Prior studies have reported low rates of follow-up with a primary care provider (PCP) after emergency department (ED) treatment for asthma. We sought to identify predictors associated with PCP follow-up. Methods. As part of a randomized trial we surveyed parents of children aged 2–18 years being discharged after ED asthma treatment. Parents described their child's asthma history and perceived benefits and barriers to making a PCP follow-up visit. Bivariate tests and multivariable logistic regression were used to determine association with completion of a follow-up visit within 4 weeks of the ED visit. Results. A total of 278 subjects (N = 278)were enrolled; 55% saw their PCP within 4 weeks of the ED visit. Baseline factors that were associated with an increased likelihood of follow-up included a recent hospitalization, more than one ED visit for asthma in the past year, the parent's assessment that the child has “very severe” asthma, and current daily use of a controller medication. Parental beliefs that taking daily asthma medications and finding out about the causes of asthma attacks were very important and were also associated with increased PCP follow-up. Parents were less likely to follow up if they reported a lack of convenient appointments or prolonged waits in the PCP office. A multivariable model including clinical factors, parental beliefs, and the study intervention predicted the likelihood of follow-up. Conclusions. Parental beliefs about asthma severity, the benefits of controlling asthma, and organizational barriers to seeing a PCP were associated with follow-up after a pediatric ED visit for asthma. |
| |
Keywords: | asthma emergency primary care children |
|
|