Effects of increased primary care access on process of care and health outcomes among patients with asthma who frequent emergency departments - 25/08/11
, Neil R. Bell, MD, MSc b, S.F. Paul Man, MD aRésumé |
Purpose |
Many asthmatic patients discharged from emergency departments do not have timely follow-up visits with a primary care physician. This study was conducted to determine the effectiveness of a health professional–based intervention in improving process of care and health outcomes among asthmatic patients discharged from emergency departments.
Methods |
We enrolled 125 asthmatic patients, aged 5 through 50 years, from the emergency department of a community-based hospital; 62 patients were assigned to usual care and 63 to enhanced care. Enhanced care consisted of usual care plus employment of a coordinator to make follow-up appointments with the patient's primary care physician with at least one reminder telephone call to the patient.
Results |
At 6 months of follow-up, mean (± SD) asthma and pediatric quality-of-life scores were higher in the enhanced care group than in the usual care group (5.7 ± 1.2 units vs. 5.0 ± 1.3 units, P = 0.01). The enhanced care group also had a higher rate of follow-up office visits (78% [n = 44] vs. 60% [n = 33], P = 0.003), were more likely to have written action plans (46% [n = 26] vs. 25% [n = 14], P = 0.02), and had fewer asthma symptoms (1.8 ± 1.1 units vs. 2.2 ± 1.3 units, P = 0.09). However, these differences disappeared by 12 months of follow-up.
Conclusion |
A simple intervention wherein a health professional facilitates follow-up visits can improve the process of care and health outcomes of high-risk asthmatic patients. However, the effect of this intervention is time limited and largely wears off by 12 months.
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| This work was supported in part by the Medical Services Budget Innovation Fund from the Alberta Medical Association, Edmonton, Alberta, Canada. Dr. Sin is supported by a Canada Research Chair (Obstructive Airways Disease) and a GSK/St. Paul's Hospital Foundation COPD Professorship. |
Vol 117 - N° 7
P. 479-483 - octobre 2004 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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