The Impact of Follow-Up Physician Visits on Emergency Readmissions for Patients With Asthma and Chronic Obstructive Pulmonary Disease: A Population-Based Study

Am J Med. 2002 Feb 1;112(2):120-5. doi: 10.1016/s0002-9343(01)01079-8.

Abstract

Purpose: To examine the relation between follow-up office visits after emergency discharge and the risk of emergency readmissions in patients with asthma or chronic obstructive pulmonary disease (COPD).

Subjects and methods: We used population-based data to identify all patients in Alberta, Canada, who had at least one emergency visit for asthma or COPD between April 1, 1996, and March 31, 1997 (N = 25 256). A Cox proportional hazards model was used to estimate the adjusted relative risk (RR) of a repeat visit to an emergency department within 90 days of an initial emergency visit in patients who did or did not have an office follow-up within the first 30 days.

Results: There were 7829 patients (31%) who had an office visit during the 30 days after their initial emergency encounter. Follow-up visits were associated with a significant reduction in the 90-day risk of an emergency readmission (RR = 0.79; 95% confidence interval [CI]: 0.73 to 0.86). Sensitivity analyses showed that a follow-up visit was inversely associated with a repeat emergency visit after adjusting for age, sex, area of residence, and income.

Conclusion: Although these data should be interpreted with caution because of missing information on factors such as quality of care, they suggest that follow-up office visits are effective in reducing early relapses in patients who have been recently treated in emergency departments for asthma or COPD.

MeSH terms

  • Acute Disease
  • Adult
  • Alberta / epidemiology
  • Asthma / epidemiology
  • Asthma / therapy*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Office Visits / statistics & numerical data*
  • Patient Admission / statistics & numerical data
  • Patient Admission / trends*
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Risk Factors