Emergency department visits by adult asthma patients have been decreasing over the past two decades

Background: Ogaki municipal hospital is a regional medical center covering population 400,000 in Japan and so many amounts of patients visited to our emergency department (ED) in a year. Asthmatic patients with acute exacerbations often visit an ED and asthma exacerbation is one of the common diseases encountered in ED. For this reason, we devoted effort to reduce ED visits by asthmatic patients through improving disease control by treatment intervention with inhaled corticosteroids (ICS) and patient education. ICS became common in middle of 1990s in Japan. Aims and objectives: The purpose of this study was to examine the incidence of ED visits for asthma and their characteristics. Methods: We reviewed retrospectively adult asthmatic patient visits to the ED of our hospital in 1992, 1999, 2002, 2008 and 2012. Results: The number of whole ED visits has increased from 25,000 in 1992 to 46,000 in 2012. However there are significant changes in rates of ED visits with asthma exacerbations. In 1992, 302 patients visited ED 942 times (2.58 visits a day). In 2012, 123 patients visited ED 174 times (0.48 visits a day). That was 82% reduction from 1992. The number of frequent ED users also decreased from 126(41.7%) to 25(20.3%). On the other hand, the rate of regular ICS utilization of the patients visited to ED increased 61% to 89.5% from 1992 to 2012. Conclusion: Emergency visits of adult asthmatic patients have steadily decreased over the past two decades. However, poor controlled asthma still remains. Additional interventions are needed for them.