Asthma in the South Bronx: clinical and epidemiologic characteristics

This study of the adult emergency room asthma population in an urban poverty area was performed to assess and enhance the effectiveness of medical treatment and community health care delivery. The number of visits for acute asthma decreased during the 3-yr period of observation despite an annual increase in the total number of emergency room visits. This was attributed to fewer multiple visits and earlier hospitalization. An analysis of adult and pediatric patients hospitalized for asthma was also performed and revealed that asthma was responsible for 25% of pediatric and 13% of adult female medical admissions. An asthma registry of 1,329 adult patients, compiled over a 12-mo period showed a 7:3 female to male ratio of 60% Puerto Rican predominance. The identification of patients usually refractory to outpatient treatment was hindered by the constant flux in the population base as illustrated by an 85% increase in the asthma registry over the succeeding 12-mo period. Since many of these patients were previously cared for at other metropolitan institutions the creation of a centralized data system making such records available to all emergency care facilities would allow for the rapid identification of refractory patients and enhance the management of their acute episodes.