Characteristics of asthmatics using an urban accident and emergency department.
The demographic characteristics of patients attending the Middlemore Hospital accident and emergency department with asthma were studied prospectively over a 3 month period. Pacific Islanders and Maoris used A & E more and were more frequently admitted because of asthma than Europeans (p less than 0.0001). Independent of race, patients living in close proximity were more likely to attend A & E and to be admitted than patients living distant from hospital (p less than 0.0001). When compared with asthmatics referred by a general practitioner, self-referred asthmatics attended more frequently out of hours (p less than 0.05) and were disproportionately of lower socioeconomic classes (p less than 0.01). Eighty two percent of asthmatics perceived A&E as the most appropriate place to have their acute attacks managed. The demographic characteristics of those using A & E suggests that there are attitudinal, organisational and financial barriers to primary health care in the community which may have contributed to a shift from community to hospital based management of acute asthma, and this may explain some of the increase in hospital admissions for asthma.
Garrett
J E
JE
Department of Respiratory Medicine, Green Lane Hospital, Auckland.
Mulder
J
J
Wong-Toi
H
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000208:ethnology / Q000628:therapy*; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005060:Europe / Q000208:ethnology; D005260:Female; D006296:Health Services / Q000639:trends*; D006297:Health Services Accessibility; D006300:Health Services Misuse / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010139:Pacific Islands / Q000208:ethnology; D010821:Physicians, Family; D011446:Prospective Studies; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014505:Urban Population