The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation

Abstract

T Th he e r re el la at ti io on ns sh hi ip p b be et tw we ee en n a as st th hm ma a a ad dm mi is ss si io on n r ra at te es s, , r ro ou ut te es s o of f a ad dm mi is ss si io on n, , a an nd d s so oc ci io oe ec co on no om mi ic c d de ep pr ri iv va at ti io on n ABSTRACT: This study aimed to explore the relationship between hospital admissions for asthma and socioeconomic deprivation. A retrospective study examined one year of hospital admissions for asthma in the West Midlands region of England (n=10,044), and in one of the region's wealthier districts, Worcester (n=251). Age standardized admission ratios (SARs) for asthma, and the routes of hospital admission, were compared with the Townsend Deprivation Index for the place of residence.Asthma SAR was strongly associated with deprivation as measured by the Townsend Index for the district of residence (Spearman rank correlation coefficient ρ=0.65; p=0.004). Asthma admission rates for all age groups, except those aged over 65 yrs, were higher in poorer districts. A significantly greater proportion of emergency admissions in poorer districts came via Accident and Emergency departments, rather than general practitioner referrals (ρ=0.76; p<0.001). Within Worcester District, SAR was associated with Townsend Index for the ward of residence (ρ=0.39; p<0.001). This remained significant after excluding repeat admissions (ρ=0.45; p<0.001).We conclude that asthma admissions are strongly associated with deprivation in the community. Differences in the health care received during acute exacerbations by asthma patients from different economic backgrounds is likely to be an important factor in this relationship.

Effect of social factors on winter hospital admission for respiratory disease: a case–control study of older people in the UK

“…In contrast to the suggestions from ecological studies, [10][11][12] but in line with other individual-level studies, [14][15][16][17][18] material deprivation was not observed to be an important independent risk factor for admission.…”

“…Several ecological studies suggest that socioeconomic status may be an important determinant of respiratory admissions, [10][11][12] but evidence at individual level is limited and conflicting. [13][14][15][16][17][18][19] A large cohort study of 14 223 adults in Copenhagen found that education and income were significant predictors of COPD admission, but unfortunately this study did not assess the impact of all important confounders.…”

Asma em escolares do Recife - comparação de prevalências: 1994-95 e 2002

“…10,28,[37][38][39][40] There is no explanation for the finding. According to Rona,18 poverty is not a risk factor for the appearance of asthma, but an aggravating factor.…”

One-Year Respiratory Outcomes of Preterm Infants Enrolled in the Nitric Oxide (to Prevent) Chronic Lung Disease Trial

“…Alternatively, re-hospitalization may act as a poor marker of severity of illness; non-biological factors such as holidays, insurance status, socioeconomic status, and provider-patient interactions may influence the decision to hospitalize a child. (27)(28)(29)(30)(31)(32)(33)(34) Similarly, there was no significant difference in parental report of "wheezing or whistling in the chest." Although a true lack of drug effect is possible, another explanation is that parents did not accurately identify wheezing.…”