Delayed Care a Major Factor in Asthma ED Visits

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Adults who delayed care and had daily or weekly asthma symptoms were most likely to visit the Emergency Department (ED) according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

Ying-Ying Meng, Dr.P.H., senior research scientist at the UCLA Center for Health Policy Research, Los Angeles, and colleagues studied 4,359 non-elderly adults who reported being diagnosed as having asthma and experiencing symptoms in the past year. Using data from the 2001 California Health Interview Survey, they examined ED visits in the previous 12 months among those adult respondents with asthma.

Delayed care for asthma because of cost or insurance limitations was found significantly associated with ED visits for those with daily or weekly symptoms as well as those with less frequent symptoms.

The investigators observed that in the severe asthma group, Latinos and women were more likely to visit the ED, whereas in the group with less severe asthma, Asian, African American and uninsured adults were more likely to visit the ED.

“Two important factors related to ED visits for asthma, frequent asthma symptoms and delays in care for asthma, can be improved with effective interventions,” write the authors. “If improvements can be made to access to quality asthma care and health care coverage, the number of ED visits for asthma care should significantly decline.”

Carlos A. Camargo, M.D., Dr.P.H., associate professor of medicine & epidemiology at Harvard Medical School and Massachusetts General Hospital, Boston, noted in an accompanying editorial that there are signs of progress, but until we find a cure, there will continue to be ED visits for asthma care. ED visits for asthma peaked in the late 1990s, and have stabilized despite the increases in both asthma prevalence and total ED visit volume.

“A critical component of access is timeliness, and for shortness of breath it is not enough to get an appointment with one’s primary care physician or a specialist in a ‘few days.’ When people cannot breathe, they will continue to seek care in EDs or other settings where they will be seen in minutes to hours and not days,” Dr. Camargo wrote.

Patient information on allergic diseases including asthma is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at http://www.acaai.org.

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