Exploring Factors Associated with the Utilization of Emergency Services by Children with Asthma in Qatar and Formulating Multilevel Recommendations to Minimize Non-Urgent Emergency Department Visits
Arafah, D
Date: 10 June 2024
Thesis or dissertation
Publisher
University of Exeter
Degree Title
Doctor of Philosophy in Medical Studies
Abstract
Background: Asthma is the most common chronic illness in children. Maintaining control of symptoms is the cornerstone of asthma management guidelines. Uncontrolled asthma is associated with increased exacerbations and greater risk of morbidity, Emergency Department (ED) visits and hospitalisations. In Qatar, there is little research ...
Background: Asthma is the most common chronic illness in children. Maintaining control of symptoms is the cornerstone of asthma management guidelines. Uncontrolled asthma is associated with increased exacerbations and greater risk of morbidity, Emergency Department (ED) visits and hospitalisations. In Qatar, there is little research on children with asthma, and no studies have investigated their utilization of emergency services. Aim: To explore factors influencing the utilization of emergency services by children with asthma in Qatar, in order to provide multi-level recommendations to enhance asthma management and reduce non-urgent ED visits. Methods: The research used a mixed-methods explanatory approach, commencing with a quantitative investigation preceding the COVID-19 pandemic (mid-2018 to end 2019). This used healthcare records to examine patterns of emergency service utilization by children with asthma in Qatar. Subsequently, two qualitative interview studies were conducted to explore the perspectives of (1) children and parents; and (2) healthcare professionals on emergency service utilization for asthma, and their suggestions for reducing future utilization. Findings: The quantitative study of 34,153 children (aged 2–14) revealed 63,561 paediatric ED visits for asthma over 18 months, predominantly involving children under 5, peaking in October and November. Factors influencing longer stays included the autumn season and critical clinical signs (e.g. low oxygen saturation, low respiratory rate). Interviews with 21 families indicated ED use due to lack of asthma management knowledge and fear. There was a call for enhanced education, detailed asthma action plans, extended consultation times, and closer access to paediatric pulmonologists. Interviews with 13 healthcare professionals mirrored these findings, adding that free and high-quality ED services in Qatar encouraged more frequent use and recognising the need for more accessible paediatric services in Primary Health Care Centers. Conclusion: Culturally tailored interventions targeting multiple levels are needed to mitigate unnecessary emergency service utilization by children with asthma in Qatar Improved documentation of key data and further research should underpin these.
Doctoral Theses
Doctoral College
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