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Abstract
Asthma is the most common chronic illness of childhood and one with a very high socioeconomic cost. It causes substantial morbidity, mortality and despite advances in the treatment of this common chronic condition, both morbidity and mortality of asthma continue to increase. Asthma isa leading cause of hospital admission and emergency visits in children. As hospitalizations account for the largest proportion of costs, they represent the area with the largest potential for savings. Moreover children with asthma use significantly more health services than other children. Describing hospitalized children and risks that may contribute to their hospitalization may reveal modifiable factors that could be operated upon to minimize such problem. Practice guidelines are being developed to standardize the management of acute asthma with the aim of improving care and safely reducing health-care costs. Measuring compliance with these guidelines is very important to detect areas of weakness that could be responsible for Inappropriate management either in the outpatient practice or for the inpatients. This can insure appropriate utilization of the hospital which is cost saving. This study aims to: 1.Deterniine the extent of utilization of Student’s Hospital by students with asthma, . including hospitalizations and ambulatory services. 2.To describe socio-economic and medical characteristic of students hospitalized for asthma, as well as their school adjustment and performance. 3.To estimate the, prevalence of preventable risk factors of hospitalization among students admitted for asthma 4.To assess the adherence of providers of care for hospitalized school children to current asthma management guidelines. The study was conducted at the Student’s Hospital in Alexandria. The Student’s Hospital provides care to health insured students. It is a descriptive study that included retrospective and cross sectional designs. The study sample consists of records of school students with asthma, using Student’s Hospital health services including records of inpatient, emergency room and allergy center of school children presenting with asthma during the year 2002. For the cross sectional study, 100 school students consecutively admitted for asthma during the year 2003 formed the sample. As regards data collection, for the retrospective study, data collection was carried out using data abstract sheets ’to review data from the records. Both interviewing and review of records were the data collection techniques for the cross sectional study. Data collected through the interview included socio-demographic and medical characteristic, details of the current exacerbation, adherence, utilization of health services for asthma during the last twelve months, patient satisfaction, knowledge about asthma, school performance, school adjustment (using school adjustment scale) and quality of life’ (using Life Quality test. Review of the inpatient medical records was carried out to obtain data about the medical care provided during the current admission. Review of health insurance booklet was carried out to verify data about utilization of health services.