Comprehensive administrative heath and survey data were assessed from all 152 emergency departments (EDs) in Ontario, Canada, concerning all 2- to 17-year-olds treated in EDs for asthma from April 2003 to March 2005. The aim was to describe the resources and asthma management strategies used by EDs, and their effect on return visits within 72 hours. 32,996 children (>9% of children with asthma in Ontario) had ≥1 visit to an ED relating to asthma; 68.5% of these visits were triaged as high acuity. 148 (97%) of EDs reported using ≥1 asthma management strategy; 74% used ≥3. The overall return-visit rate was 5.6%. According to logistic regression analyses accounting for the clustering of patients in emergency departments and controlling for patient and ED characteristics, strategies significantly associated with a reduction in return visits included preprinted order sheets and access to a paediatrician for consultation. Return visit rates were 4.4% in the 11 EDs that used both of these strategies and 6.9% in the 95 that used neither strategy.
