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Specialist Care in Individuals with Asthma Who Required Hospitalization: A Retrospective Population-Based Study.
Kendzerska, Tetyana; Aaron, Shawn D; Meteb, Moussa; Gershon, Andrea S; To, Teresa; Lougheed, M Diane; Tavakoli, Hamid; Chen, Wenjia; Kunkel, Elizabeth; Sadatsafavi, Mohsen.
Afiliação
  • Kendzerska T; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ontario, Canada; ICES, Ontario, Canada. Electronic address: tkendzerska@toh.ca.
  • Aaron SD; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ontario, Canada.
  • Meteb M; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  • Gershon AS; ICES, Ontario, Canada; Department of Medicine, University of Toronto, Ontario, Canada; Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • To T; ICES, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Research Institute, The Hospital of Sick Children, Toronto, Ontario, Canada.
  • Lougheed MD; ICES, Ontario, Canada; Kingston General Hospital Research Institute, Kingston, Ontario, Canada; Queen's University, Kingston, Ontario, Canada.
  • Tavakoli H; Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
  • Chen W; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
  • Kunkel E; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; ICES, Ontario, Canada.
  • Sadatsafavi M; Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
J Allergy Clin Immunol Pract ; 9(10): 3686-3696, 2021 10.
Article em En | MEDLINE | ID: mdl-34182160
ABSTRACT

BACKGROUND:

Patients who are at risk for severe asthma exacerbations should receive specialist care. However, the care pattern for such patients in the real world is unclear.

OBJECTIVE:

To describe the pattern of care among individuals with asthma who required hospitalization, and to identify factors associated with receiving asthma specialist care.

METHODS:

This was a retrospective population-based study using health administrative data from two Canadian provinces. Individuals aged 14 to 45 years who were newly diagnosed with asthma between 2006 and 2016 and had at least one hospitalization for asthma at or within 5 years after the initial asthma diagnosis were included. First, we calculated frequencies of primary and specialist care around the asthma diagnosis 1 year before and 2 years after in a 6-month period. Next, among individuals diagnosed with asthma by a primary care physician, we used multivariable Cox regressions to identify factors associated with receiving specialist care.

RESULTS:

For 1862 individuals included, we found that most (≥71% per time period) were cared for by primary care physicians 1 year before and 2 years after the asthma diagnosis; the percentage of individuals seen at least once by a specialist for asthma and/or asthma-related respiratory conditions during the first 6 months since the diagnosis did not exceed 40%. Among 1411 of 1862 individuals who were under primary care before the asthma diagnosis (76%), controlling for covariates, living in a rural area or a low-income neighborhood was associated with less likelihood of receiving specialist care.

CONCLUSIONS:

Despite recommendations, more than half of individuals with asthma who required hospitalization did not receive specialist care during the first 2 years since the diagnosis. Identified factors associated with receiving asthma specialist care suggested that access is an important barrier to receiving recommended care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article