Factors that contribute to readmission of paediatric asthmatic patients to the Eric Williams Medical Sciences Complex [abstract]

ABSTRACT

Asthma is the commonest respiratory disease of the paediatric population and its prevalence is increasing in all parts of the world. Repeated readmission to hospital often leads to poorer school attendance, disruption of family life and increased cost to the state. Thus, global recommendations stress preventive strategies. Previous studies of readmissions of paediatric cases in developed countries have highlighted non-compliance with preventive medication and lack of parental and patient education as some of the factors that contribute to the re-admission. The purpose of this study was to determine the factors that contribute to the readmission of paediatric patients to hospitals in Trinidad. The method adopted was a descriptive survey using a questionnaire instrument. The study population consisted of 23 consecutive parents or guardians of children, aged 3-12 years, who had two or more admissions in the last year to the Emergency Room (ER) department at the Eric Williams Medical Sciences Complex for the treatment of acute bronchial asthma. The survey was conducted over a three-day period in May 2000. We found that 74 percent of the patients were less than 8 years of age with a male predominance (57 percent). Seventy-eight percent had at least four acute asthmatic attacks in the year prior to the survey and 74 percent had visited the ER at least three times during this period with 39 percent having to be warded for further management between attacks. This may have been due to a lack of education about the disease; 65 percent of parents/guardians had received no teaching about asthma. Seventy-seven of these children missed school at least once as a result of their illness in the two months prior to the survey. In a few instances, the patients' physical activities were being curtailed by parents who thought that this would prevent the child's asthma. The parents/guardians of paediatric asthma patients with frequent re-admissions to hospital have limited knowledge of their children's disorder, despite recurrent contact with healthcare professionals during their children's ER and ward admissions. Most of these children have not received adequate preventative care between attacks. Failure of the healthcare staff to follow-up these patients in clinic and educate parents and guardians about asthma may contribute to frequent hospital admissions and poor school attendance. (AU)