Inhaled corticosteroids and allergy specialty care reduce emergency hospital use for asthma
Inhaled corticosteroids and allergy specialty care reduce emergency hospital use for asthma
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DOI：
10.1067/mai.2003.178
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发表时间：
2003-03-01
影响因子：
14.2
通讯作者：
Petitti, D
中科院分区：
文献类型：
--
作者：
Schatz, M;Cook, EF;Petitti, D
背景：哮喘的最佳吸入皮质类固醇(IC)治疗、过敏专科治疗和减少医院急救之间的相互关系尚未明确。目的：我们试图评估不同水平的IC配药和过敏专科治疗在减少随后的紧急哮喘住院使用方面的独立有效性。方法：从一个大型卫生保健组织的电子数据库中确定9608名3岁至的哮喘患者。结果是2000年哮喘住院或急诊科就诊。主要的预测因素是至少一次过敏科就诊和1999年分发的IC罐数量。分析调整了年龄、性别、保险类型和哮喘严重程度(1999年哮喘急诊医院使用、P-激动剂使用和口服皮质类固醇使用)。结果：分配7罐或更多ICs(优势比[OR]，0.64；95%CI，0.43-0.94)和过敏治疗(OR，0.73；95%CI，0.55-0.97)与随后哮喘急诊医院使用的减少相关。接受过敏症专科治疗的患者比未接受此类护理的患者更多地接受了7次或7次以上的IC治疗(24.7%对8.3%，P
Background: The interrelationships between optimal inhaled corticosteroid (IC) therapy, allergy specialist care, and reduced emergency hospital care for asthma have not been well defined.Objective: We sought to evaluate the independent effectiveness of various levels of IC dispensing and allergy specialist care in reducing subsequent emergency asthma hospital use.Methods: Asthmatic patients (n = 9608) aged 3 to 64 years were identified from an electronic database of a large health maintenance organization. The outcome was any year 2000 asthma hospitalization or emergency department visit. The main predictors were at least one allergy department visit and the number of IC canisters dispensed in 1999. Analyses were adjusted for age, sex, insurance type, and asthma severity (1999 emergency asthma hospital use, P-agonist use, and oral corticosteroid use).Results: Dispensing of 7 or more canisters of ICs (odds ratio [OR], 0.64; 95% CI, 0.43-0.94) and allergy care (OR, 0.73; 95% CI, 0.55-0.97) were associated with reduced subsequent emergency asthma hospital use. More patients with allergy specialist care than those without such care received 7 or more dispensations of ICs (24.7% vs 8.3%, P