REGIONAL DIFFERENCES IN LONG-TERM MORTALITY AMONG HOSPITAL-TREATED ASTHMA AND COPD PATIENTS

Chronic obstructive pulmonary diseases, which have increased due to sm oking and ageing of the population, constitute a national health probl em the treatment of which can be expected to arouse considerable discu ssion in health care organisations currently preoccupied with economic problems. Although extensive medication and easy access to treatment are often regarded as therapeutically desirable, it may be questioned whether they have any impact on objective measures such as mortality. International recommendations for the early treatment of asthma have m et with satisfaction and the asthma situation can be said to be under control, even though occurrences tend to be on the increase. It should be noted, however, that the COPD treatment recommendations still rema in to be tested and the general attitude towards treatment is still re served, even pessimistic. By combining data from the Finnish national hospital discharge register and register of deaths with findings regar ding the use of medications, differences in the survival of asthmatic and COPD patients can be discerned between areas with different treatm ent practices. Stressing the fact that effect-differences between diff erent treatment strategies can not be proven on the basis register dat a and that random clinical trials are needed to gain further knowledge in the held, our results show that extensive medication and easy acce ss to treatment are characteristic of areas where the survival of asth matics and COPD patients is better.