title: Adequacy of outpatient care among hospitalized adult asthmatics in a southwest US border city.
abstract: Over 3 years we studied the baseline degree of asthma severity and the adequacy of the usual medical management among asthmatics admitted to a large US-Mexican border county hospital. The study design consisted of 2 years of retrospective chart review and 1 year of prospective semistructured interview collection. Patients were at least 18 years of age and required acute care and hospital admission for asthma exacerbations. The 127 patients studied accounted for 166 hospital admissions for asthma related primary diagnoses. Most were Hispanic and medically indigent, and only 39% of patients whose asthma severity indicated the use of inhaled corticosteroid medications reported taking them. Most of the hospitalized asthmatic patients studied were on inadequate outpatient medical regimens for the baseline severity of their asthma. Underuse of inhaled corticosteroids was the predominant medication deficiency. Other shortcomings identified in their routine management included a lack of pulmonary function testing, basic asthma education, and treatment by a practitioner qualified in the care of chronic asthma.
authors.affiliation: Division of Pulmonary and Critical Medicine, Texas Technical University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas 79905, USA. Harold.Hughes@ttuhsc.edu
authors.forename: Harold  W
authors.initials: H
authors.lastname: Hughes
authors.forename: Sean M
authors.initials: SM
authors.lastname: Connery
authors.forename: José O
authors.initials: JO
authors.lastname: Rivera
authors.forename: Manuel
authors.initials: M
authors.lastname: Rivera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000208:ethnology / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care; D012189:Retrospective Studies; D015206:Southwestern United States; D013781:Texas
chemical_list: D018927:Anti-Asthmatic Agents