PURPOSE: To compare patterns of emergency department (ED) usage among adult and pediatric asthmatics in a suburban hospital setting.
METHODS: A retrospective hospital database review was conducted between 1/1/2000 and 12/31/2006. Demographics, time and day of visit, disposition, and length of stay (LOS) data were collected and analyzed.
RESULTS: The database consisted of 18,843 patients. 41% were ≤;18 years of age (“pediatric group” or PG) and 59% >18 (“adult group” or AG). In the PG 60% were male, compared with 30% male in the AG (P<0.0001). In the PG 54% reported to be white, 29% black and 11% Hispanic, while in the AG 68% were white, 23% black and 4% Hispanic (P<0.0001). 7% of the PG had Medicaid compared with 4% of the AG (P<0.001). In the PG, 27% were admitted compared with 51% of the AG (P<0.001). Of admitted patients, the mean LOS in the PG was 2.7 days compared with 6.2 days in the AG (P<0.0001). 80% of all patients came to the ED between 9AM and midnight. 37% of the PG came to the ED between 9A and 5P, compared with 47% of the AG (P<0.001), and the PG tended more to come on the weekends (31%) than the AG (26%) (P<0.001).
CONCLUSION: There were significantly more adult than pediatric ED visits. Compared with adult patients, the PG was more likely to be male, have Medicaid, and less likely to be admitted. Once admitted, children were hospitalized half the number of days as adults. Pediatric patients, compared with adults, tended to come to the ED during non-business hours (i.e. when the doctor's office was closed).
CLINICAL IMPLICATIONS: It is possible that many of these ED visits could have been prevented through improved asthma education and use of emergency action plans. Our group is currently working on an asthma questionnaire study to explore reasons parents take their children to the ED. We are also planning to implement an ED-based educational tool utilizing staff available during regular business hours.We would like to acknowledge the support of the Asthma Coalition of Long Island for this work.
DISCLOSURE: Jon Roberts, No Financial Disclosure Information; No Product/Research Disclosure Information