Patterns of inpatient and outpatient care
for asthma in Erie and NiagaraCounties, western New YorkState.
Lwebuga-Mukasa JS, Pszonak R.
Center for Asthma and Environmental Exposure, Department
of Internal Medicine, StateUniversity of New York at Buffalo, USA.
The prevalence of asthma, as well as the morbidity and mortality due to asthma,
has increased in the United States,
especially among poor minority subpopulations. The causes of these increases
are complex and not well understood. Our findings from an analysis of emergency
room (ER) visits and hospitalizations for Erie and Niagara Counties in western
New York State for the period 1984-1991 provides important background to this
problem. Of all respiratory disorders, asthma was the most frequent reason
for ER visits and was second only to pneumonia as a reason for hospital admissions.
In Erie County the hospitalization rates for asthma in two inner-city communities
with predominantly minority populations were 1.48 and 2.09 times higher than
those in the rest of the county. Furthermore, the hospitalization rates for
these communities showed an increasing trend over the study period. Gender
differences were also found. Boys age 0 to 9 years were hospitalized for asthma twice as
often as girls. However, over 15 years of age, females had admission rates
that were twice those of males. In contrast, hospitalization rates for pneumonia
were equal for males and females, which would suggest gender differences particular
to asthma. Hospitalizations for asthma in the western New York region cost
an estimated $6,000,000 in 1990. We conclude that asthma is a major cause
of morbidity in this region with excessive and increasing impact on inner-city
communities.