Predictors of primary care follow-up after a pediatric emergency visit for asthma.
OBJECTIVE
Prior studies have reported low rates of follow-up with a primary care provider (PCP) after emergency department (ED) treatment for asthma. We sought to identify predictors associated with PCP follow-up.


METHODS
As part of a randomized trial we surveyed parents of children aged 2-18 years being discharged after ED asthma treatment. Parents described their child's asthma history and perceived benefits and barriers to making a PCP follow-up visit. Bivariate tests and multivariable logistic regression were used to determine association with completion of a follow-up visit within 4 weeks of the ED visit.


RESULTS
A total of 278 subjects (N = 278) were enrolled; 55% saw their PCP within 4 weeks of the ED visit. Baseline factors that were associated with an increased likelihood of follow-up included a recent hospitalization, more than one ED visit for asthma in the past year, the parent's assessment that the child has "very severe" asthma, and current daily use of a controller medication. Parental beliefs that taking daily asthma medications and finding out about the causes of asthma attacks were very important and were also associated with increased PCP follow-up. Parents were less likely to follow up if they reported a lack of convenient appointments or prolonged waits in the PCP office. A multivariable model including clinical factors, parental beliefs, and the study intervention predicted the likelihood of follow-up.


CONCLUSIONS
Parental beliefs about asthma severity, the benefits of controlling asthma, and organizational barriers to seeing a PCP were associated with follow-up after a pediatric ED visit for asthma.
Zorc
Joseph J
JJ
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA. zorc@email.chop.edu
Scarfone
Richard J
RJ
Li
Yuelin
Y
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015143:Philadelphia; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016312:Treatment Refusal / Q000706:statistics & numerical data*