CARE OF ASTHMA - ALLERGY CLINIC VERSUS EMERGENCY ROOM

Background: Demographic and socioeconomic factors have an impact upon the morbidity and mortality rates of asthma in inner-city pediatric po pulations. Many pediatric patients with asthma use the emergency room as their primary care physician, while a smaller number of children wi th asthma use the allergy-immunology clinic. Objective: We examined th e demographic and socioeconomic characteristics of asthmatic patients using the emergency room as their primary care physician and of those attending the allergy-immunology clinic in the same inner-city hospita l. We compared the morbidity and cost of care of asthmatic patients wh o received their medical care in the emergency room to that of those w ho received their care in the allergy-immunology clinic. Methods: Fift y consecutive emergency room patients and 25 clinic patients were stud ied using an identical questionnaire. Results: There was no difference between the two groups in the total number of individuals per househo ld, children per family, monthly income, type or size of dwelling, fin ancial problems purchasing medications, health insurance type, distanc e to the medical center, or education of the caretaker. Severity of as thma was not different in the two groups before the start of the study . The only significant demographic difference was in age: 10.6 years f or the clinic group and 7.8 years for the emergency room group (P < .0 02). Clinically, in the year preceding the interview, the clinic group had significantly less nocturnal cough (P < .025), sleep interruption (P < .001), weekly asthma (P < .05), and emergency room visits (P < . 09). The allergy clinic group had an approximate average savings of $1 37 per patient per year. Hospital admissions and emergency room costs were increased by a small group of three allergy clinic patients, decr easing the difference in the cost of care between the two groups. Conc lusion: The data showed that patients who attended the emergency room and those who attended the allergy-immunology clinic were not demograp hically or socioeconomically different. The decreased morbidity of ast hma and cost of care for the allergy clinic patients, as opposed to th e emergency room patients, are likely due to the care given in the all ergy-immunology clinic.