Research

Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity

Mark D Eisner^1,2 , Patricia P Katz³, Edward H Yelin³, Stephen C Shiboski⁴ and Paul D Blanc^1,2,5

¹  Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, California, USA

²  Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, California, USA

³  Institute for Health Policy Studies, University of California, San Francisco, California, USA

⁴  Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA

⁵  Cardiovascular Research Institute, University of California, San Francisco, California, USA

author email corresponding author email

Respiratory Research 2001, 2:53-60doi:10.1186/rr37

Published:	29 December 2000

Abstract

Background

The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial.

Methods

In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization.

Results

Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4).

Conclusion

In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.