Abstract
Objectives
To (a) identify rates of hospital readmission and emergency department (ED) re-presentation for asthma within a 12-month period, (b) estimate the effects of modifiable hospital, general practitioner (GP) and home environmental factors on hospital readmission, ED re-presentations and rescue oral corticosteroid use.
Methods
We recruited 767 children aged 3–18 years who were admitted to 3 hospitals in Victoria, Australia between 2017 and 2018 with a validated diagnosis of asthma on chart review. Primary outcome was hospital readmission with asthma within 12 months of index admission. Secondary outcomes were ED re-presentation for asthma and rescue oral corticosteroid use. All outcomes were identified through linked administrative datasets. Their caregivers and 277 nominated GPs completed study surveys regarding the home environment and their usual asthma management practices respectively.
Results
Within 12 months of an index admission for asthma 263 (34.3%) participants were readmitted to a hospital for asthma, with participants between the ages of 3–5 years accounting for 69.2% of those readmitted. The estimated effect of GP reported guideline discordant care on the odds of readmission was OR 1.57, 95% CI 1.00–2.47, p = 0.05. None of the hospital or home environmental factors appeared to be associated with hospital readmissions.
Conclusions
Hospital readmissions among Australian children with asthma are increasing, and linked datasets are important for objectively identifying the health services burden of asthma. They also confirm the important role of the GP in the management of pediatric asthma.
Keywords:
Acknowledgements
The authors thank Dr. Shaoke Lei for his assistance with data analysis and Ms Rachel Pelly for her assistance with recruitment and data collection.
Disclosure statement
All authors have completed the Unified Competing Interest form (available on request from the corresponding author).
Data availability statement
The corresponding author, KC, has access to the complete study data, which can be shared on request.