Factors associated with pediatric asthma readmissions,☆☆,

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METHODS

An inception cohort consisting of all children with their first ever admission for treatment of asthma to the Hospital for Sick Children in Toronto between January 1, 1990 and July 31, 1991, and at least one readmission to the Hospital for Sick Children because of asthma within 12 months of the index admission was identified. This cohort was followed forward, with children readmitted because of asthma within 12 months of their second discharge compared with those not readmitted, on demographic

RESULTS

In all, 68 children comprised the inception cohort. Of these, 32 (47%) were readmitted because of asthma within 12 months. The risk of readmission by clinical and demographic factors is described in Table I. Age, sex, and asthma severity indicators were not associated with readmission. The median age of readmitted children was 3 years (range, 1 to 10 years) compared with a median age of 2 years (range, 1 to 13 years) for those not readmitted (p = 0.83). No child was intubated or admitted to the

DISCUSSION

Because data were collected retrospectively, with the medical chart as the primary data source, the strength of inference is dependent on the quality of the chart information. For example, the decision on hospitalization involves not only an assessment of illness severity but also consideration of social and family issues. Factors such as socioeconomic status, parental education, and compliance (either with prescribed medication use or physician instruction in the outpatient setting) were not

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From Pediatric Outcomes Research Team, Division of General Pediatrics, The Hospital for Sick Children and Department of Pediatrics, University of Toronto.

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Reprint requests: Colin Macarthur, MBChB, PhD, Division of General Pediatrics, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8.

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