Partridge M R, Latouche D, Trako E, Thurston J G
Chest Clinic, Whipps Cross Hospital, Leytonstone, London.
J Accid Emerg Med. 1997 Jan;14(1):16-20. doi: 10.1136/emj.14.1.16.
To obtain a representative national picture of the type of people with asthma attending accident and emergency (A&E) departments in the UK, the reasons why they attend, and to determine the proportion admitted to hospital.
A national census involving questionnaires.
100 A&E departments throughout the UK.
All those with asthma attending because of asthma during a one week period in September 1994.
Details were obtained about 1292 attendances. About half of all attendances were by adults and half by children, and 87.8% were previously diagnosed asthmatics; 18.8% of adult attenders were unemployed. Perceived severity of asthma was the reason for attendance in 65.5%, but 11.5% reported non-availability, or perceived non-availability, of the general practitioner (GP) as the reason for attending. One fifth of adults had been kept awake by their asthma for over three nights before attendance. 425 of the 1292 attenders (32.9%) had been admitted to hospital in the previous 12 months and 316 (24.5%) had attended the A&E department in the previous three months. Only 24.6% of attenders had had contact with their general practitioner in the previous 24 h. 61.6% of under-5 attenders (n = 341) were admitted to hospital; the figures for those aged 5-15 and 15+ years and above were 265 (41.4%) and 665 (38.7%).
Many people with asthma attend A&E departments without first having seen their GP. In many adult cases the asthma, while severe, is not acute, but a high proportion of both adults and children are admitted to hospital. Many of these attendances and admissions are repeat attendances. To enhance the quality of care provided to those with asthma may require easier access to primary care, enhanced patient education, or enhanced health professional education. Further study is needed of a variety of potential interventions.
了解英国哮喘患者前往急诊部门就诊的人员类型、就诊原因，并确定住院比例，以获取具有代表性的全国情况。
一项涉及问卷调查的全国普查。
英国各地的100个急诊部门。
1994年9月某一周内因哮喘前往就诊的所有哮喘患者。
获取了1292次就诊的详细信息。所有就诊者中约一半为成人，一半为儿童，87.8%为先前已确诊的哮喘患者；18.8%的成年就诊者失业。65.5%的就诊原因是感觉哮喘严重，但11.5%报告称是因为无法联系到或感觉无法联系到全科医生（GP）而前来就诊。五分之一的成年人在就诊前因哮喘已连续三个多晚上无法入睡。1292名就诊者中有425人（32.9%）在过去12个月内曾住院，316人（24.5%）在过去三个月内曾前往急诊部门就诊。在过去24小时内，只有24.6%的就诊者曾与他们的全科医生联系过。5岁以下就诊者（n = 341）中有61.6%住院；5至15岁以及15岁以上就诊者的住院比例分别为265人（41.4%）和665人（38.7%）。
许多哮喘患者在未首先咨询全科医生的情况下就前往急诊部门就诊。在许多成年病例中，哮喘虽严重但并非急性发作，不过成人和儿童住院比例都很高。这些就诊和住院中有许多是再次就诊。要提高为哮喘患者提供的护理质量，可能需要更便捷地获得初级医疗服务、加强患者教育或加强卫生专业人员教育。需要对各种潜在干预措施进行进一步研究。
