Admission rates as an indicator of the prevalence of severe asthma in the community.
BACKGROUND
A reliable indicator of the prevalence of severe asthma in the community is needed to monitor population-based asthma control strategies. We examined the potential use of asthma admissions to hospital as such an indicator.


METHODS
We recruited subjects from the Emergency Department (ED) of a children's hospital. The attending doctor completed the 'physician questionnaire' which included questions on the patient's asthma severity and interval severity/chronicity of asthma. The parent/guardian completed the 'parent questionnaire'. It included questions on demography, asthma knowledge and attitudes, asthma history and social support. We performed univariate and multiple logistic regression to determine predictors for hospital admission.


RESULTS
Interval severity of asthma, pre-treatment severity of wheeze and low post-treatment pulse oximetry best predicted whether children presenting with asthma were admitted. Demographic variables, factors associated with access to health services and factors related to the asthma history and management were not significant predictors of admission.


CONCLUSIONS
At the population level, it may be possible to utilise routine hospital admission rates as an indicator of the prevalence of severe asthma in the community, especially within the context of monitoring trends in asthma prevalence. Our study was conducted in a metropolitan tertiary paediatric hospital. The reliability of hospital admission rates as indicators of the prevalence of severe asthma in other hospital settings, in different population groups and over time remains to be established.
Jalaludin
B
B
Western Sector Public Health Unit, Western Sydney Area Health Service North Parramatta, NSW. binj@phu.wsahs.nsw.gov.au
Chey
T
T
Holmwood
M
M
Chipps
J
J
Hanson
R
R
Corbett
S
S
Leeder
S
S
D000293:Adolescent; D001249:Asthma / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D010290:Parents; D011159:Population Surveillance; D011237:Predictive Value of Tests; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014505:Urban Population