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UBC Theses and Dissertations

Emergency service utilization for pediatric asthma exacerbations and the potential for interventions Joseph, Jay Ashvin


Objectives: To determine whether there is a relationship between parental attendance at an asthma education clinic and repeat visits to a pediatric Emergency Department [i.e. paediatric Emergency Department] for asthma exacerbations; to explore the relationship between parental knowledge about asthma, parental information-seeking and decision-making preferences, and repeat visits to the pediatric Emergency Department for asthma exacerbations; to quantify a possible correlation between particulate matter (PM) air pollution as a result of a bog fire and pediatric Emergency Department utilization for asthma exacerbations. Methods: The British Columbia Children’s Hospital keeps a record of all emergency service utilization. Data were obtained through a combination of chart abstraction, computer system searching, and telephone follow-up with parents of children who visited the Emergency Department. PM concentration data were obtained from an air pollution monitoring stations across the Greater Vancouver Regional District. Results: Attendance at an asthma education clinic is not associated with a reduced time to repeat ED visit but may be more effective with parents of children four years of age or older and without an established history of ED visits; Attendance at a asthma education clinic does produce measurable changes in parental asthma knowledge but parental decision-making preferences do not appear to influence repeat ED visit likelihood; Elevated PM₁₀ and PM₂.₅ pollution concentrations appear to be associated with an increase, although delayed, in ED visits. Conclusions: ED visits are a viable outcome measure for healthcare utilization studies. Although asthma education and parental preferences do not affect ED visit rates elevated PM pollution concentrations during fires may result in moderate increases in ED visits.

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