Asthma attendances in the emergency department; frequency and timing

Introduction: Acute exacerbations cause major disruption to the lives of those suffering with asthma. Frequent admissions have a significant impact on healthcare resources. Timing of attendance is relevant for healthcare planning and the appropriate treatment of people with asthma. Objective: To determine the timing and frequency of attendances due to asthma to our large district general emergency department over the course of a calendar year. Methods: Hospital attendance records were used to record every attendance to ED between 01/01/15 to 31/12/15 due to asthma at our centre. This was used to ascertain the rate of attendance and variation with time, day and month. Chi-squared tests were used to compare attendance to average expected values. Results: There were 693 attendances to our Emergency Department in 2015 due to asthma, comprising 546 different patients. 50.8% of patients were admitted from the ED. 75 patients had 2 or more attendances, while 38 patients were admitted 2 or more times. Attendance was highest on Sunday and Monday, lowest on Thursday and Friday and this was statistically significant (p=0.001), but admission rates did not differ significantly (p=0.99). Attendances were significantly (p=0.02) higher in October and November (n=73-74) than in April to August (n=48-52). Attendance peaked at 6-7pm and 10-11pm, but was lowest between midnight and 8am. Conclusions: Asthma attendances at our centre were significantly higher on Sunday and Monday, in October and November and during the evenings. This analysis is important for ED and asthma workforce planning and education. We plan to target the most frequent attenders to our service in an attempt to reduce our attendance rates.