A NATIONAL CENSUS OF THOSE ATTENDING UK ACCIDENT AND EMERGENCY DEPARTMENTS WITH ASTHMA

Objective-To obtain a representative national picture of the type of p eople with asthma attending accident and emergency (A&E) departments i n the UK, the reasons why they attend, and to determine the proportion admitted to hospital. Design-A national census involving questionnair es. Setting-100 A&E departments throughout the UK. Subjects-All those with asthma attending because of asthma during a one week period in Se ptember 1994. Results-Details were obtained about 1292 attendances. Ab out half of all attendances were by adults and half by children, and 8 7.8% were previously diagnosed asthmatics; 18.8% of adult attenders we re unemployed. Perceived severity of asthma was the reason for attenda nce in 65.5%, but 11.5% reported non-availability, or perceived non-av ailability, of the general practitioner (GP) as the reason for attendi ng. One fifth of adults had been kept awake by their asthma for over t hree nights before attendance. 425 of the 1292 attenders (32.9%) had b een admitted to hospital in the previous 12 months and 316 (24.5%) had attended the A&E department in the previous three months. Only 24.6% of attenders had had contact with their general practitioner in the pr evious 24 h. 61.6% of under-5 attenders (n=341) were admitted to hospi tal; the figures for those aged 5-15 and 15+ years and above were 265 (41.4%) and 665 (38.7%). Conclusions-Many people with asthma attend A& E departments without first having seen their GP. In many adult cases the asthma, while severe, is not acute, but a high proportion of both adults and children are admitted to hospital. Many of these attendance s and admissions are repeat attendances. To enhance the quality of car e provided to those with asthma may require easier access to primary c are, enhanced patient education, or enhanced health professional educa tion. Further study is needed of a variety of potential interventions.