Abstract
Objectives:This study was designed to report factors associated with asthma hospital admission, such as patient characteristics, type of admission and subsequent outcome i.e. discharge or death, for the years 2000–2005. These data are used for health economic models regarding asthma burden in the hospital setting in Australia.Methods:Data was obtained from the Australian Centre for Asthma Monitoring using their amalgamated dataset from all states and territories. Admissions under ICD-10 codes J45 ‘Asthma’ plus all subcodes, and J46 ‘acute severe asthma’ were included. Codes for associated comorbidity at the time of admission were identified, as well as the month of death, age, gender and length and the type of stay. Confidence intervals for death rate assumed a binomial distribution because of the rarity of event.Results:The total number of all-cause deaths for the 5-year observation period was 289 from 202,739 asthma separations or 0.14% or 143 deaths/100,000 separations and the highest rate was seen in patients over 45 years. Acute upper respiratory tract infections were reported in up to 25% of all asthma hospital admissions. Length of stay was up to a mean average of 10.2 days in patients who died (SD 15.3). In 5 years observation there was 152,758 emergency asthma admissions which contributed greatly to Australian healthcare burden.Conclusions:The study demonstrates that emergency admissions dominate asthma care in the hospital setting in Australia, which suggests poor asthma control in some patients with subsequent economic burden. Asthma-related mortality remains a risk for specific patients in the hospital setting.
Highlights
Asthma is a leading cause of morbidity and can often lead to hospitalisation and in some severe cases, death
Australia has previously been reported as having the second highest prevalence of self-reported wheeze in adults 20–44 years of 41 countries surveyed in the extended European Community Respiratory Health Survey [2]
Data was taken from the Australian Institute of Health and Welfare database run in collaboration a 2007 The Authors Journal compilation a 2007 Blackwell Publishing Ltd Int J Clin Pract, November 2007, 61, 11, 1884–1888 with the Australian Centre for Asthma Monitoring, a group set up to assist in reducing the burden of asthma in Australia by developing, collating and interpreting data relevant to asthma prevention, management and health policy
Summary
Asthma is a leading cause of morbidity and can often lead to hospitalisation and in some severe cases, death. Asthma burden has both health system and social costs. In countries with a high prevalence of asthma, health resource utilisation will be greater than countries with lower prevalence. The Australian Bureau of Statistics estimates that asthma prevalence in 2004–2005 was 10% (2 million people) using the National Health Survey [1]. In a cost-effective evaluation in Australia, Simonella et al [4] calculated that optimal asthma treatment and compliance would avert the need for interventions such as hospitalisation, with a 69% saving of the current cost burden
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