Outcomes of Follow-Up Care After an Emergency Department Visit Among Pediatric Asthmatics in the Military Health System

<b>Background and Objectives</b>: Asthma exacerbations frequently trigger emergency department (ED) visits. Guidelines recommend timely follow-up after an ED visit for asthma, however, other studies have questioned the quality of follow-up care and their effect on subsequent ED utilization. We evaluated follow-up care on asthma outcomes in pediatric asthmatics enrolled in the Military Health System (MHS) after an ED visit for asthma. <b>Methods</b>: This retrospective study utilized MHS data to evaluate 2–17 year old persistent asthmatics with an ED visit for asthma between 2010–2012. Demographics, medication dispensing, and subsequent asthma related ED and hospital utilization were compared between those with or without a 28 day follow-up appointment. <b>Results</b>: 10,460 of 88,837 persistent asthmatics met inclusion criteria for an asthma ED visit. 4,964 (47.5%) had ≥ 1 follow-up visit. In the 29–365 days after their ED visit, 21.1% of the follow-up cohort required an ED re-visit compared to 24.0% of the patients without follow-up. Follow-up care was associated with a reduction in ED re-visits (adjusted hazard ratio 0.86; 95% confidence interval 0.79, 0.93). Controller medications were dispensed to 76.0% of the follow-up cohort within 90 days of their ED visit compared to 49.7% in the group without follow-up. <b>Conclusions</b>: Despite universal access to healthcare, less than half of pediatric MHS asthma patients had follow-up within 28 days of an ED visit. Those with follow-up were more likely to fill a controller medication within 90 days post ED visit, and less likely to have an asthma ED re-visit in the subsequent year.