Edinburgh Emergency Asthma Admission Service: report on 15 years' experience

Area of Science:

• Pulmonology
• Emergency Medicine
• Healthcare Management

Background:

• A hospital self-admission service for asthma patients was established in December 1968.
• Over 15 years, 195 patients accounted for 873 self-admissions.

Purpose of the Study:

• To evaluate the effectiveness and outcomes of a hospital self-admission service for asthmatic patients.
• To assess the mortality rates and resource utilization associated with the service.

Main Methods:

• Retrospective analysis of 873 hospital self-admissions by 195 asthmatic patients over a 15-year period.
• Comparison of admission patterns (time of day, duration of symptoms) between the initial and final 3 years of the study.
• Documentation of critical interventions, including assisted ventilation, and in-hospital and out-of-hospital deaths.

Main Results:

• A total of 873 self-admissions were recorded over 15 years.
• Significant increase in night admissions and shorter pre-admission asthma attack durations in the latter study period.
• Assisted ventilation was required in 4% of cases; three in-hospital deaths occurred (0.34% overall mortality).
• Six out-of-hospital deaths were reported, four attributed to asthma.

Conclusions:

• The hospital self-admission service demonstrated a low mortality rate, suggesting a life-saving impact.
• The service is cost-free and enhances patient and general practitioner confidence.
• The findings support the continued use and potential expansion of such patient-initiated healthcare access models for chronic respiratory conditions.