Reattendance at hospital for asthma in two Australian states, 2000–2003
Corresponding Author
Patricia K. CORRELL
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Patricia K. Correll, Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research, PO Box M77, Camperdown, NSW 2050, Australian. Email: [email protected]Search for more papers by this authorWei XUAN
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorMargaret WILLIAMSON
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorVijaya SUNDARARAJAN
Victorian Department of Human Services, Melbourne, Victoria, Australia
Search for more papers by this authorClare RINGLAND
New South Wales Department of Health, Sydney, New South Wales, and
Search for more papers by this authorGuy B. MARKS
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorCorresponding Author
Patricia K. CORRELL
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Patricia K. Correll, Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research, PO Box M77, Camperdown, NSW 2050, Australian. Email: [email protected]Search for more papers by this authorWei XUAN
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorMargaret WILLIAMSON
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorVijaya SUNDARARAJAN
Victorian Department of Human Services, Melbourne, Victoria, Australia
Search for more papers by this authorClare RINGLAND
New South Wales Department of Health, Sydney, New South Wales, and
Search for more papers by this authorGuy B. MARKS
Australian Centre for Asthma Monitoring, Woolcock Institute of Medical Research,
Search for more papers by this authorAbstract
Objective and background: Reattendance rates at hospitals and emergency departments (ED) can provide a valuable marker of the quality and effectiveness of clinical care. Linked hospital and ED data from New South Wales and Victoria, Australia, were used to examine reattendances for asthma.
Methods: Hospital and ED data were linked to identify individuals who reattended hospital or ED for asthma within 28 days of an initial attendance. The sociodemographic characteristics that predicted reattendance were examined using logistic regression.
Results: There were 139 043 attendances for asthma between July 2000 and June 2003 attributed to 95 042 people. Overall, 7.1% of people reattended for asthma within 28 days. There was a significantly higher risk of reattendance among females (odds ratio (OR) 1.09, 95% confidence interval (CI) 1.03–1.14), people who lived in areas of greater socioeconomic disadvantage (OR 1.20, 95% CI 1.12–1.29) and Indigenous people (OR 1.15, 95% CI 1.00–1.32). Reattendance rates differed among age groups (P < 0.001), with the lowest rate being in 5- to 14-year-olds.
Conclusion: The availability of linked hospital and ED data has provided a rare opportunity to investigate predictors of reattendance for asthma. Surveillance of trends in reattendances for asthma can be used to monitor the effectiveness of interventions to improve asthma control across the continuum of care, particularly in higher-risk groups such as Indigenous people, young children and those with greater socioeconomic disadvantage.
REFERENCES
- 1 ACAM (Australian Centre for Asthma Monitoring). Asthma in Australia 2005. AIHW cat. no. ACM 6. Australian Institute of Health and Welfare, Canberra, 2005.
- 2 Schatz M, Mosen D, Apter AJ, Zeiger RS, Vollmer WM, et al. Relationships among quality of life, severity, and control measures in asthma: an evaluation using factor analysis. J. Allergy Clin. Immunol. 2005; 115: 1049–55.
- 3 ACAM (Australian Centre for Asthma Monitoring). Health Care Expenditure and the Burden of Disease Due to Asthma in Australia. AIHW cat. no. ACM 5. Australian Institute of Health and Welfare, Canberra, 2005.
- 4 Sin DD, Man J, Sharpe H, Gan WQ, Man SF. Pharmacological management to reduce exacerbations in adults with asthma: a systematic review and meta-analysis. JAMA 2004; 292: 367–76.
- 5 Gibson PG, Powell H. Written action plans for asthma: an evidence-based review of the key components. Thorax 2004; 59: 94–9.
- 6 GINA (Global Initiative for Asthma). Global Strategy for Asthma Management and Prevention (updated 2004). National Institutes of Health: National Heart, Lung and Blood Institute, Bethesda, MD, 2002. [Accessed 2 Sep 2005.] Available from URL: http://www.ginasthma.com
- 7 Marks G, Burney P, Premaratne U, Simpson J, Webb J. Asthma in Greenwich: impact of the disease and current management practices. Eur. Respir. J. 1997; 10: 1224–9.
- 8 Marks G, Heslop W, Yates D. Prehospital management of exacerbations of asthma: relation to patient and disease characteristics. Respirology 2000; 5: 45–50.
- 9 Apter AJ, Boston RC, George M. Modifiable barriers to adherence to inhaled steroids among adults with asthma: it’s not just black and white. J. Allergy Clin. Immunol. 2003; 111: 1219–26.
- 10 Shields AE, Comstock C, Weiss KB. Variations in asthma care by race/ethnicity among children enrolled in a state Medicaid program. Pediatrics 2004; 113: 496–504.
- 11 MatchWare Technologies. Automatch Version 4.01 (software). Burtonsville, MD, USA, 1997.
- 12 SAS Institute. SAS for Windows Release 9. SAS Institute Inc., Cary, NC, USA, 2005.
- 13 ABS (Australian Bureau of Statistics). Information Paper: 1996 Census of Population and Housing: Socioeconomic Indexes for Areas. Cat. no. 2309.0. ABS, Canberra, 1998.
- 14 ABS (Australian Bureau of Statistics). ABS Views on Remoteness. Cat. no. 1244.0. ABS, Canberra, 2001.
- 15 DIMIA (Department of Immigration and Multicultural and Indigenous Affairs). English Proficiency 1996 Census. Statistical report no. 30. Department of Immigration and Multicultural Affairs, Canberra, 2001.
- 16 Ashton CM, Del Junco DJ, Souchek J, Wray NP, Mansyur CL. The association between the quality of inpatient care and early readmission: a meta-analysis of the evidence. Med. Care 1997; 35: 1044–59.
- 17 Benbassat J, Taragin M. Hospital readmissions as a measure of quality of health care: advantages and limitations. Arch. Intern. Med. 2000; 160: 1074–81.
- 18 Slack R, Bucknall CE. Readmission rates are associated with differences in the process of care in acute asthma. Qual. Health Care 1997; 6: 194–8.
- 19 Castro M, Zimmermann NA, Crocker S, Bradley J, Leven C, Schechtman KB. Asthma intervention program prevents readmissions in high healthcare users. Am. J. Respir. Crit. Care Med. 2003; 168: 1098–9.
- 20 Madge P, McColl J, Paton J. Impact of a nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax 1997; 52: 223–8.
- 21 Mayo PH, Richman J, Harris W. Results of a program to reduce admissions for adult asthma. Ann. Intern. Med. 1990; 112: 864–71.
- 22 Wesseldine LJ, McCarthy P, Silverman M. Structured discharge procedure for children admitted to hospital with acute asthma: a randomised controlled trial of nursing practice. Arch. Dis. Child. 1999; 80: 110–14.
- 23 Homer CJ, Szilagyi PG, Rodewald L, Bloom SR, Greenspan P, et al. Does quality of care affect rates of hospitalization for childhood asthma? Pediatrics 1996; 98: 18–23.
- 24 Sin DD, Bell NR, Svenson LW, Man SF. The impact of follow-up physician visits on emergency readmissions for patients with asthma and chronic obstructive pulmonary disease: a population-based study. Am. J. Med. 2002; 112: 120–5.
- 25 Heggestad T, Lilleeng SE. Measuring readmissions: focus on the time factor. Int. J. Qual. Health Care 2003; 15: 147–54.
- 26 Sibbritt DW. Validation of a 28 day interval between discharge and readmission for emergency readmission rates. J. Qual. Clin. Pract. 1995; 15: 211–20.
- 27 Chambers M, Clark A. Measuring readmission rates. BMJ 1990; 301: 1134–6.
- 28 ACHS (Australian Council on Health Care Standards). Determining the Potential to Improve Quality of Care, 6th edn. ACHS Clinical Indicator Results for Australia and New Zealand 1998–2004. ACHS, Sydney, 2005.
- 29 Elliott A. The Decline in Bulk Billing: Explanation and Implications. Current issues brief no. 3 2002–2003. Parliament of Australia Parliamentary Library, Canberra, 2002. [Accessed 11 Nov 2005.] Available from URL: http://www.aph.gov.au/library/pubs/CIB/2002-03/03CIB03.htm
- 30 Young AF. The decline in bulk-billing and increase in out-of-pocket costs for general practice consultations in rural areas of Australia, 1995–2001. Med. J. Aust. 2003; 178: 122–6.
- 31 Premaratne U, Marks G, Austin E, Burney P. A reliable method to retrieve accident and emergency data stored on a free-text basis. Respir. Med. 1997; 91: 61–6.
- 32 Farber HJ. Risk of readmission to hospital for pediatric asthma. J. Asthma 1998; 35: 95–9.
- 33 Salamzadeh J, Wong ICK, Hosker HSR, Chrystyn H. A cox regression analysis of covariates for asthma hospital readmissions. J. Asthma 2003; 40: 645–52.
- 34 Bloomberg GR, Trinkaus KM, Fisher EB, Musick JR, Strunk RC. Hospital readmissions for childhood asthma: a 10-year metropolitan study. Am. J. Respir. Crit. Care Med. 2003; 157: 1068–76.
- 35 Gurkan F, Ece A, Haspolat K, Derman O, Bosnak M. Predictors for multiple hospital admissions in children with asthma. Can. Respir. J. 2000; 7: 163–6.
- 36 Chen Y, Stewart P, Dales R, Johansen H, Scott G, Taylor G. Ecological measures of socioeconomic status and hospital readmissions for asthma among Canadian adults. Respir. Med. 2004; 98: 446–53.
- 37 Dales RE, Choi B, Chen Y, Tang M. Influence of family income on hospital visits for asthma among Canadian school children. Thorax 2002; 57: 513–17.
- 38 Goeman D, Aroni R, Sawyer S, Stewart K, Thien F, et al. Back for more: a qualitative study of emergency department reattendance for asthma. Med. J. Aust. 2004; 180: 113–17.