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Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada

BACKGROUND: There is a lack of real-world research assessing asthma management following asthma-related emergency department (ED) discharges. The objective of this study was to characterise follow-up care, healthcare resource use (HCRU) and medical costs following ED admissions in Alberta, Canada. M...

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Autores principales: Mayers, Irvin, Randhawa, Arsh, Qian, Christina, Talukdar, Manisha, Soliman, Mena, Jayasingh, Pramoda, Johnston, Karissa, Bhutani, Mohit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668303/
https://www.ncbi.nlm.nih.gov/pubmed/37914234
http://dx.doi.org/10.1136/bmjresp-2023-001934
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author Mayers, Irvin
Randhawa, Arsh
Qian, Christina
Talukdar, Manisha
Soliman, Mena
Jayasingh, Pramoda
Johnston, Karissa
Bhutani, Mohit
author_facet Mayers, Irvin
Randhawa, Arsh
Qian, Christina
Talukdar, Manisha
Soliman, Mena
Jayasingh, Pramoda
Johnston, Karissa
Bhutani, Mohit
author_sort Mayers, Irvin
collection PubMed
description BACKGROUND: There is a lack of real-world research assessing asthma management following asthma-related emergency department (ED) discharges. The objective of this study was to characterise follow-up care, healthcare resource use (HCRU) and medical costs following ED admissions in Alberta, Canada. METHODS: A retrospective cohort study was conducted on adults with asthma using longitudinal population-based administrative data from Alberta Health Services. Adult patients with asthma and ≥1 ED admission from 1 April 2015 to 31 March 2020 were included. ED admissions, outpatient visits, hospitalisations and asthma-specific medication use were measured in the 30 days before and up to 90 days after each asthma-related ED admission. Mean medical costs attributable to each type of HCRU were summarised. All outcomes were stratified by patient baseline disease severity. RESULTS: Among 128 063 patients incurring a total of 20 142 asthma-related ED visits, a substantial rate of ED readmission was observed, with 10% resulting in readmissions within 7 days and 35% within 90 days. Rates increased with baseline asthma severity. Despite recommendations for patients to be followed up with an outpatient visit within 2−7 days of ED discharge, only 6% were followed up within 7 days. The mean total medical cost per patient was $C8143 in the 30 days prior to and $C5407 in the 30 days after an ED admission. CONCLUSIONS: Despite recommendations regarding follow-up care for patients after asthma-related ED admissions, there are still low rates of outpatient follow-up visits and high ED readmission rates. New or improved multidimensional approaches must be integrated into follow-up care to optimise asthma control and prevent readmissions.
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spelling pubmed-106683032023-11-01 Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada Mayers, Irvin Randhawa, Arsh Qian, Christina Talukdar, Manisha Soliman, Mena Jayasingh, Pramoda Johnston, Karissa Bhutani, Mohit BMJ Open Respir Res Asthma BACKGROUND: There is a lack of real-world research assessing asthma management following asthma-related emergency department (ED) discharges. The objective of this study was to characterise follow-up care, healthcare resource use (HCRU) and medical costs following ED admissions in Alberta, Canada. METHODS: A retrospective cohort study was conducted on adults with asthma using longitudinal population-based administrative data from Alberta Health Services. Adult patients with asthma and ≥1 ED admission from 1 April 2015 to 31 March 2020 were included. ED admissions, outpatient visits, hospitalisations and asthma-specific medication use were measured in the 30 days before and up to 90 days after each asthma-related ED admission. Mean medical costs attributable to each type of HCRU were summarised. All outcomes were stratified by patient baseline disease severity. RESULTS: Among 128 063 patients incurring a total of 20 142 asthma-related ED visits, a substantial rate of ED readmission was observed, with 10% resulting in readmissions within 7 days and 35% within 90 days. Rates increased with baseline asthma severity. Despite recommendations for patients to be followed up with an outpatient visit within 2−7 days of ED discharge, only 6% were followed up within 7 days. The mean total medical cost per patient was $C8143 in the 30 days prior to and $C5407 in the 30 days after an ED admission. CONCLUSIONS: Despite recommendations regarding follow-up care for patients after asthma-related ED admissions, there are still low rates of outpatient follow-up visits and high ED readmission rates. New or improved multidimensional approaches must be integrated into follow-up care to optimise asthma control and prevent readmissions. BMJ Publishing Group 2023-11-01 /pmc/articles/PMC10668303/ /pubmed/37914234 http://dx.doi.org/10.1136/bmjresp-2023-001934 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Asthma
Mayers, Irvin
Randhawa, Arsh
Qian, Christina
Talukdar, Manisha
Soliman, Mena
Jayasingh, Pramoda
Johnston, Karissa
Bhutani, Mohit
Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title_full Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title_fullStr Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title_full_unstemmed Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title_short Asthma-related emergency admissions and associated healthcare resource use in Alberta, Canada
title_sort asthma-related emergency admissions and associated healthcare resource use in alberta, canada
topic Asthma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668303/
https://www.ncbi.nlm.nih.gov/pubmed/37914234
http://dx.doi.org/10.1136/bmjresp-2023-001934
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