CHARACTERISTICS OF HOSPITALIZATION FOR ASTHMA AMONG PERSONS LESS-THAN-35 YEARS OF AGE IN CHICAGO

Mortality from asthma in Chicago is among the highest in the nation fo r 5-34-year-olds. Data for all hospitalizations among Chicago resident s less than 35 years of age were examined to define characteristics th at may be contributing to morbidity and mortality from asthma. From 19 87 through 1989, the average annual age-adjusted hospitalization rate among persons less than 35 years of age in Chicago was 3.57 per 1000 p ersons. There were significant associations of community hospitalizati on rate with median income (r = -0.61, p < 0.001) and with proportion of community asthma hospitalizations using Medicaid, Medicare, or self -payment (r = 0.69, p < 0.001). Among 18-34-year-old men, asthma hospi talization rates for Medicaid recipients were 17.4-34.1-fold higher th an among men using other forms of insurance. Asthma admissions using M edicaid, Medicare, or self-payment were more likely than those using o ther forms of insurance to present through the emergency department (7 9.3% and 66.4%, respectively, p < 0.001) and be discharged against med ical advice (1.8% vs. 0.7%, respectively, p < 0.001). These data sugge st that differential access to or utilization of health care may be co ntributing to asthma morbidity in Chicago.