Back for more: a qualitative study of emergency department reattendance for asthma

Objective: To explore the reasons why individuals recurrently present with asthma to hospital emergency departments. Design: A predominantly qualitative study in which participants were interviewed in‐depth about their asthma. Data on medication use, respiratory health and asthma knowledge were also...

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Bibliographic Details
Published in:Medical journal of Australia 2004-02, Vol.180 (3), p.113-117
Main Authors: Goeman, Dianne P, Thien, Francis C K, Douglass, Jo A, Aroni, Rosalie A, Abramson, Michael J, Sawyer, Susan M, Stewart, Kay
Format: Article
Language:English
Subjects:
Adult
Aged
Ambulatory care
Asthma
Asthma - epidemiology
Asthma - prevention & control
Asthma - psychology
Australia
Biological and medical sciences
Chronic obstructive pulmonary disease, asthma
Emergency medical care
Emergency medicine
Emergency Service, Hospital - statistics & numerical data
Female
Health care
Health Services Misuse - statistics & numerical data
Health surveys
Humans
Infections
Interviews
Male
Medical sciences
Middle Aged
Patient Education as Topic
Patient Readmission - statistics & numerical data
Pneumology
Preventive medicine
Qualitative Research
Questionnaires
Respiratory tract diseases
Self Care
Statistics, Nonparametric
Teaching hospitals
Utilization Review
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Summary:Objective: To explore the reasons why individuals recurrently present with asthma to hospital emergency departments. Design: A predominantly qualitative study in which participants were interviewed in‐depth about their asthma. Data on medication use, respiratory health and asthma knowledge were also collected, and asthma severity was determined from medical records. Setting: A tertiary teaching hospital and a suburban hospital emergency department (ED) from 1 March to 30 April 2000, and a rural hospital ED from 1 July to 31 August 2000. Participants: The participation rate was 32% of an initial 195 ED attendees (183 of whom were eligible) aged 18–70 years: 32 had presented to an ED for asthma care on more than one occasion over the preceding 12 months (reattendees), and 29 were non‐reattendees. Results: Two‐thirds (22/32) of reattendees had chronic severe asthma and presentation to ED was deemed appropriate for 18 of these, indicated by recurrent severe asthma attacks despite seeking prior medical intervention. Reasons for re‐presentation identified in a third of all reattendees included poor asthma knowledge, and financial and other barriers to medication use. Conclusions: We identified potentially preventable issues in about a third of patients (most of whom had mild to moderate asthma) who recurrently presented to EDs for treatment. The remainder of the participants sought emergency asthma treatment appropriately after failing to respond to medical care, and this was frequently in accordance with their asthma management plans.
ISSN:0025-729X
1326-5377
DOI:10.5694/j.1326-5377.2004.tb05831.x