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Delayed care fuels asthma-related ER visits

AsthmaFeb 23, 06

Adults with asthma, even those with mild asthma, who delay seeking care because of cost or lack of insurance, are apt to end up in the emergency room, results of a study suggest.

Increasing ER visits for asthma care, the authors charge, represent “an alarming consequence of the current trends in health care coverage of increasing premiums, individual contributions, deductibles, and co-payments and decreasing numbers of people being insured.”

“If improvements can be made to access to quality asthma care and health care coverage, (ER) visits for asthma should significantly decline,” Dr. Ying-Ying Meng from the University of California in Los Angeles told Reuters Health.

“Delay in care,” Meng explained, “means that respondents reported delaying or not getting needed health care in the previous 12 months—such as prescription medications, needed medical care (e.g. seeing a doctor, a specialist or other professional), as well as any tests or treatments a doctor ordered.”

In 2002, Americans made 1.9 million visits to ERs for asthma care, Meng and colleagues note in the Annals of Allergy, Asthma and Immunology. Use of the ER for asthma care is a costly, inconvenient, and largely preventable form of treatment, they point out. Yet, little is known about how to reduce the number of people using the ER for asthma care.

Meng’s team looked for modifiable factors related to ER visits for asthma among 4,359 adults reporting asthma symptoms in the previous 12 months.

They found that the odds of visiting the ER were greatest for adults who reported daily or weekly asthma symptoms, had fair or poor health status, and delayed seeking care from their regular doctor due to money or insurance constraints.

“Even among those with the mildest asthma,” Meng said, delays in seeking care were related to ER visits.

To prevent ER visits for asthma, “it is important to control asthma symptoms,” Meng and colleagues conclude, noting that in the current study, 28 percent of adults had poor asthma control.

However, it is “equally if not more important,” they point out, to reduce delays in receiving asthma care. This will likely require improvements in access to quality asthma care as well as health care coverage.

Commenting on the report, Dr. Carlos A. Camargo, Jr. from Harvard Medical School notes that while ER visits for asthma “remain unacceptably high,” there are signs of progress. ER visits for asthma, he points out, peaked in the late 1990s and have stabilized despite the increase in both asthma prevalence and total ER visit volume.

SOURCE: Annals of Allergy Asthma and Immunology, February 2006.

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