Aims According to Asthma UK: an estimated 75% of admissions are avoidable. Although, national data is available there is paucity of local data. We have aimed to produce a local demographic of asthma visitors at a district general hospital as a part of an improvement project.
Methods This is an observational study in which 414 children under the age of 18 in the year of 2011 were identified according to a diagnosis of either viral induced wheeze (VIW) or asthma. Database tools were used to parse the data and stratify the repeat visitors. An automated system was established for future use. Patient outcomes and management offered on discharge were noted and compared to British Thoracic Society (BTS) discharge guidelines.
Out of 414 children, 353 attended accident and emergency (A&E) once, whereas 61 (15%) children attended repeatedly (≥2 visits) due to Asthma or VIW. Out of 513 visits there was an average admission rate of 21%.
There was no seasonal variation in admission rates between single and repeat visitors.
Less than 5% of children with repeat visits were given personalised written plans as recommended by Asthma UK.
Conclusion Asthma is the most common chronic medical condition affecting childhood in the United Kingdom. A 21% admission rate in repeat visitors is high in comparison to good units and the majority of patients were not discharged according to BTS discharge guidelines. Furthermore repeat visitors contribute to over 30% of all asthma related visits. Hence, we have identified a potential cost effective opportunity focussing on repeat visitors. Future projects will be aimed at improving the discharge planning process in A&E. This is particularly relevant as prior asthma admissions or A&E visits are the strongest risk factors for subsequent A&E visits.
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