Table 1.
Post-Hospitalization Care and Arrangements
| Questions | Total | % | (95% CI) | Fb | p-value | ED | % | (95% CI) | Pediatric Ward | % | (95% CI) | Fc | p-value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (n)a | (n) | (n) | |||||||||||
| Clinical practice guidelines used (n=482) | 469 | 97.3 | (95.4–98.6) | 0.7 | 0.78 | 270 | 97.5 | (94.9–98.9) | 199 | 97.1 | (93.7–98.9) | 0.1 | 0.79 |
| Follow-up advice given (n=488) | 485 | 99.3 | (98.2–99.8) | 0.7 | 0.75 | 273 | 98.9 | (96.9–99.8) | 212 | 100 | (98.3–100) | 2.3 | 0.13 |
| Process to ensure follow-up appointment attended (n=400) | 33 | 8.3 | (5.7–11.4) | 1.4 | 0.16 | 7 | 3.2 | (1.3–6.5) | 26 | 14.3 | (9.5–20.2) | 16.1 | 7.1×10−5 |
| How is follow-up appointment advised? (n=481) | |||||||||||||
| Verbally to parent/carer | 368 | 76.5 | (72.5–80.2) | – | – | 203 | 74.6 | (69.0–79.7) | 165 | 78.9 | (72.8–84.3) | – | – |
| Discharge letter to GP | 395 | 82.1 | (78.4–85.4) | – | – | 219 | 80.5 | (75.3–85.1) | 176 | 84.2 | (78.5–88.9) | – | – |
| Discharge letter given to parent/carer | 349 | 72.6 | (68.3–76.5) | – | – | 191 | 70.2 | (64.4–75.6) | 158 | 75.6 | (69.2–81.2) | – | – |
| Discharge letter to pediatrician | 63 | 13.1 | (10.2–16.4) | – | – | 15 | 5.5 | (3.1–8.9) | 48 | 22.9 | (17.4–29.3) | – | – |
| Discharge letter to respiratory specialist | 27 | 5.6 | (3.7–8.1) | – | – | 6 | 2.2 | (0.8–4.7) | 21 | 10 | (6.3–14.9) | – | – |
| What is the usual timeframe between leaving hospital and the subsequent follow-up appointment? (n=414) | |||||||||||||
| 2–3 days | 312 | 75.4 | (70.9–79.4) | – | – | 191 | 86.4 | (81.2–90.7) | 121 | 62.7 | (55.5–69.5) | – | – |
| 4–6 days | 70 | 16.9 | (13.4–20.8) | – | – | 23 | 10.4 | (6.7–15.2) | 47 | 24.4 | (18.5–31.0) | – | – |
| >6 days | 32 | 7.7 | (5.3–10.7) | – | – | 7 | 3.2 | (1.3–6.4) | 25 | 12.9 | (8.6–18.5) | – | – |
| When a child with asthma/wheeze is discharged from your ward/department, who is responsible for making the follow-up appointment/s? (n=480) | |||||||||||||
| Hospital staff | 53 | 11.4 | (8.4–14.2) | – | – | 15 | 5.5 | (3.1–8.9) | 38 | 18.3 | (13.3–24.2) | – | – |
| Parent/carer | 390 | 81.3 | (77.5–84.6) | – | – | 240 | 88.2 | (83.8–91.8) | 150 | 72.1 | (65.5–78.1) | – | – |
| Both | 37 | 7.7 | (5.5–10.5) | – | – | 17 | 6.3 | (3.7–9.8) | 20 | 9.6 | (6.0–14.5) | – | – |
| Asthma action plan provided (n=475) | 421 | 88.6 | (85.4–91.3) | 4.4 | 2.3x10–8 | 213 | 80.9 | (75.7–85.5) | 208 | 98.1 | (95.2–99.5) | 34.1 | 9.4×10−9 |
| Asthma education provided (n=468) | 451 | 96.4 | (94.2–97.9) | 0.9 | 0.5 | 249 | 94.3 | (90.8–96.8) | 202 | 99 | (96.5–99.9) | 7.3 | 0.007 |
| What type of asthma education is provided to the parents/carers? (n=449) | |||||||||||||
| Face-to-face formal session | 120 | 26.7 | (22.7–31.1) | – | – | 34 | 13.7 | (9.7–18.6) | 86 | 42.8 | (35.8–49.9) | – | – |
| Face-to-face casually throughout the admissions/presentations | 386 | 85.9 | (82.4–89.0) | – | – | 219 | 88.3 | (83.6–92.0) | 167 | 83 | (77.2–88.0) | – | – |
| Provision of written resources | 305 | 67.9 | (63.4–72.2) | – | – | 163 | 65.7 | (59.5–71.6) | 142 | 70.6 | (63.8–76.8) | – | – |
| Details for accessing digital/online resource | 50 | 11.1 | (83.8–14.4) | – | – | 17 | 6.9 | (4.0–10.7) | 33 | 16.4 | (11.6–22.3) | – | – |
| Which of the following written or digital/online resources are provided to the parents/carers? (n=301) | |||||||||||||
| Locally developed resource pack/handout/brochure | 81 | 26.9 | (21.9–32.3) | – | – | 40 | 25.3 | (18.7–32.8) | 41 | 28.9 | (21.6–37.1) | – | – |
| Sydney Children’s Hospitals Network factsheets | 209 | 69.4 | (63.9–74.6) | – | – | 110 | 69.6 | (61.8–76.7) | 99 | 69.7 | (61.5–77.1) | – | – |
| Asthma and Your Child | 78 | 25.9 | (21.1–31.3) | – | – | 24 | 15.2 | (99.8–21.8) | 54 | 38 | (30.0–46.5) | – | – |
| Asthma Australia Brochures | 19 | 6.3 | (3.8–9.7) | – | – | 11 | 7 | (3.5–12.1) | 7 | 4.9 | (2.0–9.9) | – | – |
| National Asthma Council Brochures | 22 | 7.3 | (4.6–10.9) | – | – | 10 | 6.3 | (3.1–11.3) | 12 | 8.5 | (4.4–14.3) | – | – |
| Asthma websites/apps | 9 | 3 | (1.4–5.6) | – | – | 5 | 3.2 | (1.1–7.2) | 4 | 2.8 | (0.7–7.1) | – | – |
| Culturally and linguistically appropriate asthma information | 16 | 5.3 | (3.1–8.5) | – | – | 3 | 1.9 | (0.4–5.4) | 12 | 8.5 | (4.4–14.3) | – | – |
| Written or online resources provided (n=425) | 343 | 80.7 | (76.6–84.4) | 1.9 | 0.02 | 186 | 76.9 | (71.0–82.0) | 157 | 85.7 | (79.9–90.5) | 5.3 | 0.02 |
| Awareness of community asthma service (n=234) | 105 | 44.9 | (38.4–51.5) | 2.5 | 9.3x10−4 | 37 | 38.1 | (28.5–48.6) | 68 | 49.6 | (41.0–58.3) | 3.0 | 0.08 |
| School notified about child’s discharge (n=359) | 15 | 4.2 | (2.4–6.8) | 1.1 | 0.31 | 4 | 2 | (0.5–5.0) | 11 | 7 | (3.5–12.1) | 5.5 | 0.02 |
Notes: na=number of participants responded “Yes” to the questions; Fb=Rao and Scott chi square tests for differences among LHDs; Fc =Rao and Scott chi square tests for differences between EDs and paediatric wards.
Abbreviations: 95% CI, 95% confidence interval; GP, general practitioner; ED, emergency department.