Emergency department resource use by patients with migraine and asthma in a health maintenance organization

OBJECTIVE: To identify and compare the resources consumed by patients with symptoms of asthma or migraine who presented to the Walk-In Emergency Department (WIED). DESIGN: Chart review. SETTING: WIED, Group Health Cooperative of Puget Sound, Seattle, WA. PATIENTS: Identified via WIED records as having visited the WIED between October 1991 and February 1992 for migraine or asthma. MAIN OUTCOME MEASURES: Time spent in the WIED, medications administered during visit and prescribed at discharge, diagnostic procedures performed, referrals, and hospitalizations. RESULTS: Of 16,755 WIED visits during the study period, 323 (1.9%) were migraine related and 159 (1.0%) were asthma related. Ninety percent of the asthma patients and 62% of the migraine patients reported having self-medicated prior to going to the WIED; 89% of the migraine patients received additional medication at the WIED versus 57% of the patients with asthma. Fifty-four (35.5%) of the migraine patients and 7 (4.6%) of the asthma patients had more than 1 WIED visit during the study period. CONCLUSIONS: Patients with asthma and migraine present striking contrasts in the types of resources used during WIED visits. This descriptive research highlights the need for further evaluation of the appropriateness of the healthcare services provided.

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