The association of asthma education centre characteristics on hospitalizations and emergency department visits in Ontario: a population-based study

Abstract

BackgroundInternational guidelines recommend patient education as an essential component of optimal asthma management. Since 1990 hospital-based asthma education centres (AECs) have been established in Ontario, Canada. It is unknown whether patient outcomes are related to the level of services provided.MethodsUsing linked, population-based health administrative and hospital survey data we analyzed a population of patients aged 2 to 55 years with a hospitalization for asthma (N = 12 029) or a high acuity asthma emergency department (ED) visit (N = 63 025) between April 2004 and March 2007 and followed for three years. Administrative data documenting individuals’ attendance at AECs were not available. Poisson models were used to test the association of potential access to various AEC service models (outpatient service availability and in-hospital services) with asthma readmissions, ED visits or death within 6 to 36 months following the index admission or ED visit.ResultsFifty three of 163 acute care hospitals had an AEC (N = 36) or had access by referral (N = 17). All AECs documented use with guideline-based recommendations for AE programs. ED patients having access to an AEC that offered full-time, extended hours had reduced rates of adverse outcomes (adjusted relative rate [aRR] 0.78, 95% confidence interval [CI] 0.69, 0.90) compared to those with no AEC access. Hospitalized patients with access to asthma education during hospitalization had reduced rates of adverse events (aRR 0.87, 95% CI 0.75, 1.00) compared to those with no inhospital AEC access.ConclusionAlthough compliant with asthma guideline-based program elements, on a population basis access to asthma education centres is associated only with a modest benefit for some admitted and ED patients and depends on the level of access to services provided. Review of both services provided and strategies to address potential barriers to care are necessary.

Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas

“… 18 Other studies conducted within the last 5 years using different methods have shown similar results. 19 , 20 One study conducted in an inpatient hospital setting demonstrated that solely providing education to the patient resulted in similar benefits with respect to hospitalizations and ED visits. 19 …”

“…19,20 One study conducted in an inpatient hospital setting demonstrated that solely providing education to the patient resulted in similar benefits with respect to hospitalizations and ED visits. 19 In this present study, most of the parents/caregivers of asthmatic children reported increased knowledge in managing their children's asthma symptoms, triggers, and signs. They further endorsed fewer hospitalizations/ED visits and decreased school absenteeism associated with this education.…”

Effect of asthma education on health outcomes in children: a systematic review

“…During the screening, some studies were excluded because of incomplete data, and others were excluded for their study design23–28; we only included longitudinal studies. Some studies were excluded because the participants of asthma education were not only children 29–31. We just included studies that met our inclusion criteria.…”

“…Some studies were excluded because the participants of asthma education were not only children. [29][30][31] We just included studies that met our inclusion criteria.…”