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

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 Towns- end Deprivation Index for the place of residence. Asthma SAR was strongly associated with deprivation as measured by the Towns end Index for the district of residence (Spearman rank correlation coefficient rho = 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 (rho = 0.76; p < 0.001). Within Worcester District, SAR was associated with Townsend Index for the ward of residence (rho = 0.39; p < 0.001). This remained significant after excluding repeat admissions (rho = 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.

This article has been cited by other articles:

				S M S Smith, C Mitchell, S D Bowler, C Heneghan, and R Perera The health behaviour and clinical characteristics of ambulance users with acute asthma Emerg. Med. J., March 1, 2009; 26(3): 187 - 192. [Abstract] [Full Text] [PDF]

				E. Chen, L. S. Chim, R. C. Strunk, and G. E. Miller The Role of the Social Environment in Children and Adolescents with Asthma Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 644 - 649. [Abstract] [Full Text] [PDF]

				L. Forbes, S. Harvey, R. Newson, D. Jarvis, C. Luczynska, J. Price, and P. Burney Risk factors for accident and emergency (A&E) attendance for asthma in inner city children Thorax, October 1, 2007; 62(10): 855 - 860. [Abstract] [Full Text] [PDF]

				S. Stewart, N.F. Murphy, J.J.V. McMurray, P. Jhund, C.L. Hart, and D. Hole Effect of socioeconomic deprivation on the population risk of incident heart failure hospitalisation: An analysis of the Renfrew/Paisley Study Eur J Heart Fail, December 1, 2006; 8(8): 856 - 863. [Abstract] [Full Text] [PDF]

				L. Nepomnyaschy and N. E. Reichman Low Birthweight and Asthma Among Young Urban Children Am J Public Health, September 1, 2006; 96(9): 1604 - 1610. [Abstract] [Full Text] [PDF]

				I. H. Yen, E. H. Yelin, P. Katz, M. D. Eisner, and P. D. Blanc Perceived Neighborhood Problems and Quality of Life, Physical Functioning, and Depressive Symptoms Among Adults With Asthma Am J Public Health, May 1, 2006; 96(5): 873 - 879. [Abstract] [Full Text] [PDF]

				L. D. Lynd, A. J. Sandford, E. M. Kelly, P. D. Pare, T. R. Bai, J. M. FitzGerald, and A. H. Anis Reconcilable Differences: A Cross-sectional Study of the Relationship Between Socioeconomic Status and the Magnitude of Short-Acting {beta}-Agonist Use in Asthma Chest, October 1, 2004; 126(4): 1161 - 1168. [Abstract] [Full Text] [PDF]

				X. Basagana, J. Sunyer, M. Kogevinas, J.-P. Zock, E. Duran-Tauleria, D. Jarvis, P. Burney, and J. M. Anto Socioeconomic Status and Asthma Prevalence in Young Adults: The European Community Respiratory Health Survey Am. J. Epidemiol., July 15, 2004; 160(2): 178 - 188. [Abstract] [Full Text] [PDF]

				A. Hansell, J. Hollowell, R. McNiece, T. Nichols, and D. Strachan Validity and interpretation of mortality, health service and survey data on COPD and asthma in England Eur. Respir. J., February 1, 2003; 21(2): 279 - 286. [Abstract] [Full Text] [PDF]

				C. V. Pollack Jr, E. S. Pollack, J. M. Baren, S. R. Smith, P. G. Woodruff, S. Clark, C. A. Camargo, and for the Multicenter Airway Research Collaboration A Prospective Multicenter Study of Patient Factors Associated With Hospital Admission From the Emergency Department Among Children With Acute Asthma Arch Pediatr Adolesc Med, September 1, 2002; 156(9): 934 - 940. [Abstract] [Full Text] [PDF]

				G Ng Man Kwong, C Das, A R Proctor, M K B Whyte, and R A Primhak Diagnostic and treatment behaviour in children with chronic respiratory symptoms: relationship with socioeconomic factors Thorax, August 1, 2002; 57(8): 701 - 704. [Abstract] [Full Text] [PDF]

				R E Dales, B Choi, Y Chen, and M Tang Influence of family income on hospital visits for asthma among Canadian school children Thorax, June 1, 2002; 57(6): 513 - 517. [Abstract] [Full Text] [PDF]

				A. L. Kozyrskyj, C. A. Mustard, and F. E. R. Simons Socioeconomic Status, Drug Insurance Benefits, and New Prescriptions for Inhaled Corticosteroids in Schoolchildren With Asthma Arch Pediatr Adolesc Med, November 1, 2001; 155(11): 1219 - 1224. [Abstract] [Full Text] [PDF]

				D. Sarfati and K. M. Scott A Moment in Time: Selected Results from the 1996-1997 New Zealand Health Survey Health Educ Behav, June 1, 2000; 27(3): 296 - 306. [Abstract] [PDF]

				J. Benbassat and M. Taragin Hospital Readmissions as a Measure of Quality of Health Care: Advantages and Limitations Arch Intern Med, April 24, 2000; 160(8): 1074 - 1081. [Abstract] [Full Text] [PDF]

				R. J Rona Asthma and poverty Thorax, March 1, 2000; 55(3): 239 - 244. [Full Text]

				W.-C. LEUNG Effect of environmental tobacco smoke on peak flow variability Arch. Dis. Child., October 1, 1999; 81(4): 372b - 372. [Full Text]

				A. Giuffrida, H. Gravelle, and M. Roland Measuring quality of care with routine data: avoiding confusion between performance indicators and health outcomes BMJ, July 10, 1999; 319(7202): 94 - 98. [Abstract] [Full Text]

				E Duran-Tauleria and R J Rona Geographical and socioeconomic variation in the prevalence of asthma symptoms in English and Scottish children Thorax, June 1, 1999; 54(6): 476 - 481. [Abstract] [Full Text]

				H Moudgil and D Honeybourne Differences in asthma management between white European and Indian subcontinent ethnic groups living in socioeconomically deprived areas in the Birmingham (UK) conurbation Thorax, June 1, 1998; 53(6): 490 - 494. [Abstract] [Full Text]

				S. J Roberts, J H Baumer, C. J Currie, M. Evans, C. L Morgan, C. Griffiths, P. Sturdy, J. Naish, G. Feder, R. Omar, et al. Ratio of inhaled corticosteroid to bronchodilator as indicator of quality of asthma prescribing BMJ, March 1, 1997; 314(7081): 680 - 680. [Full Text]