Asthma hospital discharges associated with pneumonia and influenza in Washington, DC 1997-2004

The District of Columbia has one of the nation's highest asthma rates. Although this condition can occur in all facets of the population, recent studies indicate that most children with asthma are in low-income and minority populations. One effective preventive measure of hospitalization is the influenza vaccine. It is estimated that fewer than 10% of children and 40% of adults with asthma receive this vaccine yearly.

Objective To assess asthma hospitalizations and its implications with associated respiratory diseases.

Methodology Hospital discharges from 1997-2004 were analyzed using SPSS. All diagnoses of asthma were used, regardless of discharge position. Data were analyzed by age, gender, race, and insurance status. Logistic regression has been used to assess the relative risk of being diagnosed with a co-morbid respiratory disease. Spatial analysis was done to determine directional distribution of hospital discharges.

Results The highest proportion of asthma diagnoses, out of total hospital discharges, was observed in the 1-4 and 5-14 age-specific groups with 24.4% and 18.7%, respectively. There was a three-fold higher risk of having a diagnosis for influenza in those hospitalized and diagnosed with asthma (p<.05). When mapped by zip code, dramatic disparities are revealed. Those areas of low socio-economic status are the most likely to be discharged due to an asthma hospitalization.

Conclusion Vaccination for influenza in those under 15 years of age with known asthma could potentially reduce the number and severity of hospitalizations for asthma. Administering the influenza vaccine could result in substantial savings in related health care costs.