title: Asthma presentations by children to emergency departments in a Canadian province: a population-based study.
abstract: BACKGROUND
  Asthma has a high prevalence in North American children and exacerbations presenting to the emergency department (ED) setting are common.
  
  
  OBJECTIVE
  Describe the epidemiology of asthma presentations to EDs by children residing in a large geographic area (Alberta, Canada).
  
  
  METHODS
  Data were extracted from provincial administrative databases for children <18 years of age from April 1999 to March 2005. Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Analysis included summaries and rates.
  
  
  RESULTS
  A total of 94,187 ED visits for asthma (45,385 children) were obtained. Visits were more common by boys (61.3%); after age 14, more females presented. The standardized rates remained stable over time; 21.1/1,000 in 1999/2000 compared to 19.8/1,000 in 2004/2005. Welfare recipients and Aboriginals had higher rates than other groups. Important daily, weekly, and monthly trends were seen. Approximately 10% were admitted; 5.4% of those discharged had a repeat ED visit within 7 days and 71% had not completed a non-ED follow-up visit within 7 days. The median time to the first follow-up visit was 26 days.
  
  
  CONCLUSIONS
  Acute asthma is an important and relatively common ED presentation in childhood. Despite guidelines and improved treatments, this study failed to identify decreased presentation rates over time; disparities were based on age, sex, and socio-economic/cultural status. Few children were reassessed within a week of their ED visit. Further study is required to understand the factors associated with these variations and the effectiveness of interventions targeted at specific groups to reduce the asthma-related ED visits.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Rosychuk
authors.forename: Donald C
authors.initials: DC
authors.lastname: Voaklander
authors.forename: Terry P
authors.initials: TP
authors.lastname: Klassen
authors.forename: Ambikaipakan
authors.initials: A
authors.lastname: Senthilselvan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Marrie
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
mesh_terms: D000293:Adolescent; D000416:Alberta / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors