Medical care access and asthma-related hospitalization

Abstract

<b>Background</b>: At present, asthma represents a substantial burden on health care resources especially in developing countries. It is important to understand the potential barriers to medical care that challenge vulnerable populations. <b>Aim</b>: To identify indicators of medical care access among asthma-related hospitalized patients in pulmonology department of mongi slim hospital. <b>Methods</b>: A retrospective study included patients with asthma, who were admitted for exacerbation; during the period from 2018 to 2022. Patients were divided into two groups:G1:patients with insurance coverage, G0:patients without insurance coverage. <b>Results:</b> The study included 113 patients, with an estimated sex ratio (male/female) of 1,77. The mean age was 44.5±15.1 years. The median age of onset of asthma was 27±12.3years. Most patients(65,3%) were treated in primary care medicine only and have never visited a specialist;and 11.4% never consulted after diagnosis. Only 26.2% of them had pulmonary function tests and skin tests. G1 represented 59,3%(n=67)and G0 represented 40.7%(n=46). Patients in G0 had more uncontrolled asthma(52.3%vs22.1%;p=0.002). A regular treatment with inhaled corticosteroids is found in 76.8% of patients of G1 vs 21.3% of patients of G0(p=0.001). Exacerbations and emergency visits was more frequent in G0 (7.13vs2.33,p=0.001). Hospital stay was longer in G0 (10 days vs 5 days;p=0.03). Oral corticosteroids are most commonly used in patients of G0(23.1% vs 0%;p=0.001). Patients of G0 were more likely to have depression and anxiety compared with those of G1 (mean HAD score was 13 in G0 vs 8 in G1;p=0.05). <b>Conclusion</b>: Gaps in health insurance coverage and medical care access may complicate asthma management and increase emergency department use and hospitalization.