Karetzky M S
J Allergy Clin Immunol. 1977 Dec;60(6):383-90. doi: 10.1016/0091-6749(77)90070-7.
This study of the adult emergency room asthma population in an urban poverty area was performed to assess and enhance the effectiveness of medical treatment and community health care delivery. The number of visits for acute asthma decreased during the 3-yr period of observation despite an annual increase in the total number of emergency room visits. This was attributed to fewer multiple visits and earlier hospitalization. An analysis of adult and pediatric patients hospitalized for asthma was also performed and revealed that asthma was responsible for 25% of pediatric and 13% of adult female medical admissions. An asthma registry of 1,329 adult patients, compiled over a 12-mo period showed a 7:3 female to male ratio of 60% Puerto Rican predominance. The identification of patients usually refractory to outpatient treatment was hindered by the constant flux in the population base as illustrated by an 85% increase in the asthma registry over the succeeding 12-mo period. Since many of these patients were previously cared for at other metropolitan institutions the creation of a centralized data system making such records available to all emergency care facilities would allow for the rapid identification of refractory patients and enhance the management of their acute episodes.
这项针对城市贫困地区成年急诊室哮喘患者群体的研究，旨在评估并提高药物治疗和社区医疗服务的有效性。在3年的观察期内，尽管急诊室就诊总数逐年增加，但急性哮喘的就诊次数却有所减少。这归因于多次就诊次数减少以及住院时间提前。对因哮喘住院的成年和儿科患者也进行了分析，结果显示哮喘占儿科医疗入院人数的25%，占成年女性医疗入院人数的13%。在12个月期间编制的1329名成年患者的哮喘登记册显示，女性与男性的比例为7:3，其中60%为波多黎各人。由于人口基数不断变化，确定通常对门诊治疗难治的患者受到了阻碍，如哮喘登记册在随后的12个月期间增加了85%。由于这些患者中的许多人以前在其他大都市机构接受治疗，因此创建一个集中数据系统，使所有急诊护理机构都能获取此类记录，将有助于快速识别难治性患者，并加强对其急性发作的管理。
