The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

CHANGES IN ASTHMA ADMISSION AND PRIMARY PAYER OVER 10 YEARS IN THE UNITED STATES

A. Patel1, A. A. Divani1, J. Zhou1, R. Pakdaman1, M. Abdelmoula1, K. Fennelly2


Objective: The objective is to study how source of admission, payment methods and discharge outcomes have changed over 10 years for asthma related hospitalizations in the United States (US).

Method: We carried out retrospective data analysis. All asthma hospitalizations in the US were identified using 1994, 1999 and 2004 National Inpatient Sample (NIS) databases. NIS is the largest all-payer care database that is publicly available in the US, containing data from 5 to 8 million hospital stays from about 1000 hospitals sampled to approximate a 20-percent stratified sample of the US community hospitals. Patients admitted with primary diagnosis of Asthma [International Classification of Disease, 9th Revision (ICD-9) code = 493] were identified from NIS database for analysis.

Results: Asthma related hospitalizations comprised about 1.3%, 1.3% and 1.1% of all hospital admissions in the US in 1994, 1999 and 2004 respectively. Admission through emergency room visits remained the main source of admission (~ 64% – 72 %). About 90 % of patients were discharged to home after asthma admissions. Asthma related in-hospital deaths ranged between 0.3% and 0.5%. Medicare, Medicaid and HMOs were the most common primary payer for admission related costs.

Conclusions: Difference between emergency room admissions and routine admissions requires more efforts to provide better resources to asthma patients to maintain better patient-compliance to treatment. Medicaid and Medicare-covered population (younger and elderly) needs to be further studied in order to judge the conditions need to be modified and to control the disease related admission better.

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