Characteristics of predominantly nonwhite patients with frequent hospitalizations for acute asthma in Chicago

The purpose of this study was to determine the characteristics of predominantly nonwhite patients with recurrent visits to the emergency department (ED) and admissions to an inner-city hospital in Chicago for acute asthma. Over a 21-month period, two groups of age and gender-matched individuals with asthma seen at the University of Illinois at Chicago Medical Center were studied: group I included 26 patients with frequent visits to the ED and no more than one admission for acute asthma/year; and group II included 28 patients with recurrent visits to the ED and two or more admissions for acute asthma/year. We found that 70% of all patients (38/54) were females and 72% (39/54) were African-Americans. The latter predominated in group II (25/28; 89%). There were no significant differences in public aid recipients. baseline FEV1, type of antiasthma medications used, and illicit drug use between the two groups. However, group II reported more asthma onset before the age of 11 years and used higher daily doses of inhaled corticosteroids than group I (p < 0.05). The average duration of hospital stay in group II was significantly longer (3.3+/-0.4 days vs. 2.4+/-0.3 days, respectively, mean+/-SEM, p < 0.05), and the average cost per hospitalization in group II significantly exceeded that of group I ($5122+/-$590 vs. $3740+/-$450, respectively, p < 0.05). We conclude that African-American females are seen more frequently in the ED for acute asthma and admitted to the hospital in Chicago. They develop asthma before the age of 11 years, use higher daily doses of inhaled corticosteroids, and contribute significantly to the high cost of asthma care.