Commentary on "Factors Associated with Emergency Department Visits in Asthma Exacerbation"
AbstractAlthough the more regular use of inhaled corticosteroids (ICS) in patients with moderate to severe asthma has led to a reduction in admission rates for exacerbations,1 rates of emergency department (ED) visits remain unacceptably and inexplicably high.2 Previous work has shown that nonwhite race, low socioeconomic status, and greater asthma severity are associated with ED visits, but these factors do not fully explain the variation in the use of emergency services.3,4 In this issue of the Southern Medical Journal, Wells et al further explore the conundrum by examining factors associated with ED visits in an underserved and low income population using retrospective data obtained from three ambulatory care centers.5 The purpose of the study was to provide data for quality improvement programs designed to reduce ED utilization among patients with asthma. The study was designed as a case–control analysis wherein cases consisted of asthmatics with one or more ED visit during a 2-year time period, and controls consisted of asthmatics with one or more outpatient clinic visits but no ED visits during the same 2 years.
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