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Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity.

Authors
Eisner-MD; Katz-PP; Yelin-EH; Shiboski-SC; Blanc-PD
Source
Respir Res 2001 Jan; 2(1):53-60
NIOSHTIC No.
20029673
Abstract
BACKGROUND: The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial. METHODS: In adults with health care access, we prospectively studied 242 with asthma, aged 18-50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization. RESULTS: Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1-8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9-1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7-6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1-33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0-9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02-1.4). CONCLUSION: In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.
Keywords
Chronic-exposure; Respiratory-irritants; Respiratory-function-tests; Pulmonary-function; Pulmonary-system; Surveillance-programs; Age-factors; Racial-factors; Education; Psychological-effects; Psychological-responses; Respiratory-system-disorders; Pulmonary-system-disorders; Demographic-characteristics
Contact
Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, California
CODEN
RREEBZ
Publication Date
20010101
Document Type
Journal Article
Email Address
eisner@itsa.ucsf.edu
Funding Amount
372965
Funding Type
Grant
Fiscal Year
2001
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003480
Issue of Publication
1
ISSN
1465-9921
Priority Area
Research Tools and Approaches: Social and Economic Consequences
Source Name
Respiratory Research
State
CA
Performing Organization
Cardiovascular Research Institute, The University of California, San Fransico California
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