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May 9, 2000

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Quicker Asthma Diagnoses May Lower Hospital Admission Rates for Elderly

Doctors can lower hospital admission rates of older asthma patients if they diagnose asthma problems earlier and control other illnesses, according to a new study by Johns Hopkins researchers. The study was designed to find out why older adults are hospitalized for asthma at much higher rates than younger adults.

"Medical care is actually better for older individuals, 65 and over, than younger adults," says Greg Diette, M.D., an assistant professor of pulmonary and critical care medicine at the Hopkins School of Medicine. "Worse health can explain the different rates of hospitalizations."

Studies have shown that adults aged 65 and over are hospitalized at more than twice the rate of individuals 18 to 35. The question was whether older adults got worse care, had worse asthma, or more co-morbid conditions, or whether doctors were just more likely to hospitalize the elderly.

In their Managed Health Care Association Outcomes Management System Asthma Project, Diette and his colleagues gathered and analyzed information from 6,572 sicker-than-average asthmatic individuals. They looked at co-morbid conditions, gender, race, education, asthma symptom severity, medications, health care access and satisfaction, and physician specialty. All subjects were employees and dependents of some of the largest U.S. companies and had health insurance coverage through managed care.

The researchers found that medical care was actually better for older adults and that the higher rates of hospitalization were due to more severe asthma and more co-morbid illnesses. Diette believes that older individuals may have worse asthma because some doctors attribute asthmatic symptoms to other diseases first and thus miss early diagnosis of asthma. Failure to provide treatment at an early stage can lead to a higher risk of hospitalization.

"We may be able to decrease hospitalizations by having doctors recognize severe symptoms of asthma earlier and increasing scrutiny for other co-morbid factors," says Diette.

This research was presented at the American Thoracic Society's conference on May 9.

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