Presentations to EDs in Alberta, Canada, for pneumonia: a large population-based study.

Abstract

Pneumonia is an infection of the lung and a common presentation problem in EDs. The objective of this study was to describe the epidemiology of pneumonia presentations to EDs in the province of Alberta, Canada. Provincial administrative databases were used to obtain all ED encounters for pneumonia during 6 fiscal years (April 1999 to March 2005). Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates. A total of 190,896 ED visits for pneumonia were made by 140,913 distinct individuals (average of 1.4 visits per individual). Most (80.6%) had only one pneumonia-related ED visit. Male patients presented in slightly higher numbers than female patients. Standardized visit rates decreased overall from 12.5/1,000 population in 1999-2000 to 9.1/1,000 in 2004-2005. Admission occurred in 28.2% of the cases. In a discharged subset, 4.8% had a repeat ED visit within 7 days. Overall, 67.0% of individuals had yet to have a non-ED follow-up visit by 1 week; the estimated median time to the first follow-up visit was 21 days (95% CI, 20-22). Pneumonia is a common presenting problem in Alberta EDs, and further study is required to understand the factors associated with the variation in presentations. Findings include a decrease in presentations after the first fiscal year, disparities based on age, sex, and socioeconomic/cultural status, and a low rate of early follow-up.