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在一项哮喘教育项目开展后的3年里,因哮喘相关病症前往急诊科和初级保健机构就诊的情况。

Use of emergency departments and primary care visits for asthma related conditions in the 3 years following an asthma education program.

作者信息

Gaudreau Katherine, Stryhn Henrik, Sanford Carolyn, Cheverie Connie, Conklin Janette, Hansen Judy, Zelman Mitchell, McClure Carol

机构信息

Consulting Epidemiologist, Kincardine , ON , Canada .

出版信息

J Asthma. 2014 Apr;51(3):288-93. doi: 10.3109/02770903.2013.873453. Epub 2014 Jan 13.

Abstract

BACKGROUND

This study examines changes in Primary Care Visits (PCVs) and Emergency Department Visits (EDVs) among 1918 patients with asthma who attended either two visits, one visit or were no-show referrals at the Dr. Patrick Gill Asthma Education Center (AEC) in Charlottetown Prince Edward Island (PEI) between January 1, 2003 and March 31, 2008 compared to 2799 controls selected from a list of PEI asthma patients developed for the Canadian Chronic Disease Surveillance System (CCDSS).

METHODS

Hurdle regression was used to model counts of PCVs and negative binomial models were used to model counts of EDVs at 12 months prior to AEC contact and 0-1, >1 to 2 and >2 to 3 years after AEC contact. The PEI Research Board approved the project.

RESULTS

No-show referrals had a significant increase in pediatric EDVs and PCVs in the first year after referral. The higher rates of PCVs and EDVs prior to contact with the AEC in patients referred to the AEC were reduced after contact with the AEC, although they remained significantly higher than the CCDSS controls.

CONCLUSIONS

Compared to patients who attended the AEC, referred patients who did not attend the AEC did not achieve similar reductions in pediatric EDVs and PCVs in the first year after referral.

摘要

背景

本研究调查了2003年1月1日至2008年3月31日期间,在爱德华王子岛夏洛特敦的帕特里克·吉尔哮喘教育中心(AEC)就诊的1918例哮喘患者的初级保健就诊(PCV)和急诊科就诊(EDV)的变化情况,这些患者分别进行了两次就诊、一次就诊或未按转诊要求就诊,同时与从为加拿大慢性病监测系统(CCDSS)编制的爱德华王子岛哮喘患者名单中选取的2799名对照进行比较。

方法

采用障碍回归模型对AEC接触前12个月以及AEC接触后0 - 1年、>1至2年和>2至3年的PCV计数进行建模,采用负二项式模型对EDV计数进行建模。爱德华王子岛研究委员会批准了该项目。

结果

未按转诊要求就诊的患者在转诊后的第一年,儿科EDV和PCV显著增加。转诊至AEC的患者在与AEC接触前PCV和EDV发生率较高,与AEC接触后有所降低,尽管仍显著高于CCDSS对照组。

结论

与到AEC就诊的患者相比,未到AEC就诊的转诊患者在转诊后的第一年,儿科EDV和PCV并未实现类似程度的降低。

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