title: Health-service use by children with asthma over a 6-month period.
abstract: OBJECTIVE
  The present study aims to describe the use of health services by children with asthma, and examine disease-specific, parental and sociodemographic variables associated with different levels of health-service utilization.
  
  
  METHODS
  Parents of 135 children attending an emergency room (ER) completed questionnaires measuring the children's asthma symptoms, and sociodemographic and psychological variables. Parents were contacted monthly for 6 months to document the number of planned and unplanned visits to hospital and community health-care services for asthma.
  
  
  RESULTS
  At least one further unplanned visit to the ER was made by 37% of children, while 62% made at least one unplanned visit to a general practitioner (GP). Fifty-five per cent made planned review visits to a GP, 30% to paediatricians and 5% to hospital clinics. After controlling for the level of asthma symptoms, parental anxiety and parental perceptions of children's vulnerability were associated with unplanned GP visits (P = 0.05 and P = 0.01, respectively); a planned review visit and the child being admitted to hospital for the index attack were associated with unplanned ER visits (P = 0.05 and P = 0.004, respectively).
  
  
  CONCLUSIONS
  Children with asthma more frequently attend GP services than hospital services for both planned and unplanned asthma management. Different variables predict the unplanned use of GP and ER services. Understanding these differences is imperative if children and families are to make the most effective use of health services.
authors.affiliation: Department of Paediatrics and Child Health, Flinders University, Bedford Park, Clinical Services, South Australia. nicola.spurrier@flinders.edu.au
authors.forename: N J
authors.initials: NJ
authors.lastname: Spurrier
authors.forename: R
authors.initials: R
authors.lastname: Staugas
authors.forename: M G
authors.initials: MG
authors.lastname: Sawyer
authors.forename: M A
authors.initials: MA
authors.lastname: Wakefield
authors.forename: R E
authors.initials: RE
authors.lastname: Ruffin
authors.forename: J
authors.initials: J
authors.lastname: Jureidini
authors.forename: F
authors.initials: F
authors.lastname: Arney
authors.forename: P
authors.initials: P
authors.lastname: Baghurst
mesh_terms: D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007223:Infant; D008297:Male; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013021:South Australia; D014600:Utilization Review