Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/10002
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Type: | Journal article |
Title: | Factors associated with hospital admissions and repeat emergency department visits for adults with asthma |
Author: | Adams, R. Smith, B. Ruffin, R. |
Citation: | Thorax, 2000; 55(7):566-573 |
Publisher: | British Med Journal Publ Group |
Issue Date: | 2000 |
ISSN: | 0040-6376 1468-3296 |
Statement of Responsibility: | Robert J Adams, Brian J Smith, Richard E Ruffin |
Abstract: | BACKGROUND---A small proportion of patients with asthma account for a disproportionate number of acute health service events. To identify whether factors other than severity and low socioeconomic status were associated with this disproportionate use, a prospective study was undertaken to examine management and psychosocial factors associated with increased risk for admission to hospital with asthma and repeat visits to the emergency department over a 12 month period. METHODS---A total of 293 patients with moderate or severe asthma managed at least in part at two teaching hospitals completed surveys of clinical status, acute events, sociodemographic, and psychological variables. RESULTS---Twenty three percent had a single admission to hospital and 16% had two or more hospital admissions. Twenty six percent had one emergency department visit and 32% had two or more visits to the emergency department. In a multiple logistic regression model, adjusted for age, sex, education and income, odds ratios (95% CI) for baseline factors associated with hospital admissions over the next 12 months were: moderate severity compared with severe asthma 0.6 (0.2 to 0.9); no hospital admissions in the past 12 months 0.1 (0.01 to 0.2); not possessing a written asthma action plan 4.0 (1.5 to 10.7); less use of an avoidance coping style 0.4 (0.3 to 0.7); lower preferences for autonomy in asthma management decisions 1.4 (0.96 to 2.0). Adjusted odds ratios (95% CI) for repeat emergency department visits were: moderate asthma severity 0.3 (0.1 to 0.8); current regular use of oral corticosteroids 10.0 (3.1 to 32.4); a hospital admission in the past 12 months 2.9 (1.8 to 4.8); not possessing a written asthma action plan 2.2 (1.1 to 5.6); less dislike of asthma medications 0.7 (0.5 to 0.9). CONCLUSIONS---In addition to factors relating to severity, not possessing a written asthma action plan, avoidance coping, and attitudes to self-management were related to acute use of health services in this at risk group. Interventions need to address or take these factors into account to reduce asthma morbidity. |
Keywords: | asthma emergency room visits hospital admissions |
DOI: | 10.1136/thorax.55.7.562 |
Published version: | http://thorax.bmj.com/content/vol55/issue7/ |
Appears in Collections: | Aurora harvest Medicine publications |
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hdl_10002.pdf | 151.38 kB | Publisher's PDF | View/Open |
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