Use of emergency departments and primary care visits for asthma related conditions in the 3 years following an asthma education program

Abstract

Background: This study examines changes in Primary Care Visits (PCVs) and Emergency Department Visits (EDVs) among 1918 patients with asthma who attended either two visits, one visit or were no-show referrals at the Dr. Patrick Gill Asthma Education Center (AEC) in Charlottetown Prince Edward Island (PEI) between January 1, 2003 and March 31, 2008 compared to 2799 controls selected from a list of PEI asthma patients developed for the Canadian Chronic Disease Surveillance System (CCDSS). Methods: Hurdle regression was used to model counts of PCVs and negative binomial models were used to model counts of EDVs at 12 months prior to AEC contact and 0–1, >1 to 2 and >2 to 3 years after AEC contact. The PEI Research Board approved the project. Results: No-show referrals had a significant increase in pediatric EDVs and PCVs in the first year after referral. The higher rates of PCVs and EDVs prior to contact with the AEC in patients referred to the AEC were reduced after contact with the AEC, although they remained significantly higher than the CCDSS controls. Conclusions: Compared to patients who attended the AEC, referred patients who did not attend the AEC did not achieve similar reductions in pediatric EDVs and PCVs in the first year after referral.

• Asthma education
• emergency department
• healthcare utilization
• hurdle models
• office visit
• primary care
• Prince Edward Island

Acknowledgements

The authors thank the Canadian Chronic Disease Surveillance System (Public Health Agency of Canada) for the creation of techniques for extracting pertinent information from Provincial administrative databases.