CHARACTERISTICS OF PREDOMINANTLY NONWHITE PATIENTS WITH FREQUENT HOSPITALIZATIONS FOR ACUTE ASTHMA IN CHICAGO

The purpose of this study was to determine the characteristics of pred ominantly nonwhite patients with recurrent visits to the emergency dep artment (ED) and admissions to an inner-city hospital in Chicago for a cute asthma. Over a 21-month period, two groups of age and gender-matc hed individuals with asthma seen at the University of Illinois at Chic ago Medical Center were studied: group I included 26 patients with fre quent visits to the ED and no more than one admission for acute asthma /year; and group II included 28 patients with recurrent visits to the ED and two or more admissions for acute asthma/year. We found that 70% of all patients (38/54) were females and 72% (39/54) were African-Ame ricans. The latter predominated in group II (25/28; 89%). There were n o significant differences in public aid recipients. baseline FEV1, typ e of antiasthma medications used, and illicit drug use between the two groups. However, group II reported more asthma onset before the age o f 11 years and used higher daily doses of inhaled corticosteroids than group I (p < 0.05). The average duration of hospital stay in group II was significantly longer (3.3+/-0.4 days vs. 2.4+/-0.3 days, respecti vely, mean+/-SEM, p < 0.05), and the average cost per hospitalization in group II significantly exceeded that of group I ($5122+/-$590 vs. $ 3740+/-$450, respectively, p < 0.05). We conclude that African-America n females are seen more frequently in the ED for acute asthma and admi tted to the hospital in Chicago. They develop asthma before the age of 11 years, use higher daily doses of inhaled corticosteroids, and cont ribute significantly to the high cost of asthma care.