Reasons for racial differences in A & E attendance rates for asthma

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Higher accident and emergency (A&E) department utilization by Pacific Islanders and Maoris with asthma has been observed.
• Existing research has not fully elucidated the reasons behind this disparity in healthcare access.

Purpose of the Study:

• To investigate if racial differences in asthma severity account for the increased A&E use among Pacific Islanders and Maoris.
• To identify contributing factors beyond intrinsic asthma severity.

Main Methods:

• A comparative study of A&E users at Middlemore Hospital and asthmatics utilizing urgent medical services.
• Analysis of reported asthma symptoms, medication use, time lost from work/school, and hospital service utilization across ethnic groups.

Main Results:

• Europeans reported more daytime asthma symptoms and used more medications compared to Pacific Islanders; Maoris were intermediate.
• Maoris and Pacific Islanders lost more time from work/school and used hospital services more relative to their perceived asthma severity than Europeans.
• Pacific Islanders demonstrated less self-management skill; both Pacific Islanders and Maoris were less likely to use prophylactic medications.

Conclusions:

• Increased A&E use by Maori and Pacific Island asthmatics is not attributable to intrinsic asthma severity.
• Ethnic, socioeconomic, and sociocultural factors, including reduced self-management and lower use of prophylactic medications, likely explain the disparities in A&E utilization and increased morbidity.