Utilization of Emergency Services by Children with Asthma in Qatar

Abstract

Background: Asthma is a leading chronic disease in children worldwide, which if left untreated or poorly controlled, can lead to altered lung function and poor quality of life. 1 Early detection and improved control of asthma are recommended to decrease utilization of emergency services and hospitalizations. Respiratory diseases are the most common conditions seen in Pediatric Emergency Centers (PECs) in Qatar. 2 The five PECs are an essential point of healthcare access for severely sick children, however, many people utilize them for potentially preventable reasons. 3 Methods: This was a quantitative retrospective observational study of children with asthma utilizing the five PECs during 2019. More than 18 variables were extracted from routine healthcare records, and data were analyzed via descriptive statistics using STATA to understand the characteristics of the population. Results: There were 41,343 visits to PECs due to asthma in 2019 from 18,382 children of more than 100 different nationalities. Around 60% were boys aged 2 to 13 years, with the peak of utilization in October and November (Figure 1) and during the day between 2:00 PM to 10:00 PM. The majority were seen in less than 30 mins (93%) and stayed in the PEC for 2 hours or less (84%) (Figure 2). Most did not have fever and 88% received Salbutamol. Around 900 children were admitted (1.6%) and almost 20 children attended once a month or more. Conclusion: From the severity of the cases, length of stay, prescriptions, and health care providers' notes, it was clear that many PEC Emergency Department (ED) visits due to asthma were preventable. Hence; appropriate preventative medical care, education, and follow-ups are recommended to reduce hospital admissions and re-attendance. Understanding the characteristics and pattern of visits amongst this population will guide future qualitative research to explore reasons for attendance in more depth and identify potential opportunities for interventions to reduce ED attendances.