title: Health service accessibility and deaths from asthma.
abstract: BACKGROUND
  Good access to health services may be important for effective asthma management amongst patients, thus preventing unnecessary deaths. In a previous study, we found elevated levels of asthma mortality in English local authority districts with poor access to acute hospitals. Here, the relationship between asthma mortality and access to primary and secondary services within the rural region of East Anglia is examined.
  
  
  METHODS
  A geographically based descriptive study, within 536 electoral wards in the region of East Anglia, England. Regression analysis was used to examine the relationship between health service accessibility, and mortality from asthma during the period January 1985 to December 1995.
  
  
  RESULTS
  After controlling for confounding factors, there was a significant tendency for asthma mortality to increase with travel time to hospital, with a relative risk of 1.07 for each 10-minute increase in journey time (P = 0.04). There was no consistent trend for mortality to increase with travel time to general practitioner surgeries.
  
  
  CONCLUSIONS
  The results of this study support the conclusions of earlier work that inaccessibility of acute hospital services may increase the risk of asthma mortality. The provision of good access to these facilities may be one factor in reducing the burden of avoidable deaths from asthma.
authors: School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, UK.
authors: A P
authors: AP
authors: Jones
authors: G
authors: G
authors: Bentham
authors: C
authors: C
authors: Horwell
mesh_terms: D001249:Asthma / Q000401:mortality*; D004739:England / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D016012:Poisson Distribution; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk