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Experimental Biology 2010: Primary Care Follow-Up After Emergency Department Visits For Lower Respiratory Illnesses Among A Disadvantaged Urban Pediatric Population
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Primary Care Follow-Up After Emergency Department Visits For Lower Respiratory Illnesses Among A Disadvantaged Urban Pediatric Population
D.B. Liberman1, D.M. Quint2, R.J. McCarter2, S.J. Teach1,2 1 Emergency Medicine, Children's National Medical Center, Washington, DC 2 Center for Clinical and Community Research, Children's National Medical Center, Washington, DC
Purpose of Study: To determine and compare FU rates with PCPs after ED discharge among disadvantaged urban pediatric patients with lower respiratory illnesses. Methods Used: Retrospective cohort study of a random sample of patients followed within the primary care system of an urban pediatric tertiary care center and discharged from its ED with an isolated diagnoses of acute asthma (ages 2-6y and 7-12y), bronchiolitis (0-24m), croup (6m-6y), or pneumonia (0-6y) during 2007. Data collected included driving distance from patient's home to PCP's office and explicitness of written ED discharge instructions in specifying FU. Rates of PCP FU within 7d and 30d were determined with electronic records. Summary of Results: Data from 467 study subjects are presented in the Table. For the entire cohort, the odds of FU significantly decreased for each 1 year increase in age [OR 0.85 (95% CI 0.78-0.93)] while they significantly increased if explicit discharge instructions were provided [OR 1.67 (95% CI 1.06-2.6)]. Conclusions: Rates of FU were low and positively associated with younger age and receiving explicit discharge instructions. The odds of FU were significantly higher for patients with acute pneumonia (0-6y) than those with an acute exacerbation of chronic asthma (2-6y). 
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