The impact of follow-up physician visits on emergency readmissions for patients with asthma and chronic obstructive pulmonary disease: a population-based study.
OBJECTIVE
To examine the relation between follow-up office visits after emergency discharge and the risk of emergency readmissions in patients with asthma or chronic obstructive pulmonary disease (COPD).


METHODS
We used population-based data to identify all patients in Alberta, Canada, who had at least one emergency visit for asthma or COPD between April 1, 1996, and March 31, 1997 (N = 25 256). A Cox proportional hazards model was used to estimate the adjusted relative risk (RR) of a repeat visit to an emergency department within 90 days of an initial emergency visit in patients who did or did not have an office follow-up within the first 30 days.


RESULTS
There were 7829 patients (31%) who had an office visit during the 30 days after their initial emergency encounter. Follow-up visits were associated with a significant reduction in the 90-day risk of an emergency readmission (RR = 0.79; 95% confidence interval [CI]: 0.73 to 0.86). Sensitivity analyses showed that a follow-up visit was inversely associated with a repeat emergency visit after adjusting for age, sex, area of residence, and income.


CONCLUSIONS
Although these data should be interpreted with caution because of missing information on factors such as quality of care, they suggest that follow-up office visits are effective in reducing early relapses in patients who have been recently treated in emergency departments for asthma or COPD.
Sin
Don D
DD
Department of Medicine, Pulmonary Division, University of Alberta, Edmonton, Alberta, Canada.
Bell
Neil R
NR
Svenson
Lawrence W
LW
Man
S F Paul
SF
D000208:Acute Disease; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors