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Open access for asthmatics

Asthma patients from surgeries who have good access to primary care, such as in their GP surgery, are less likely to be admitted to hospital because of their condition. This is the conclusion of our study at the University of East Anglia which looked at access scores for GP surgeries and compared them to the number of patients from that practice needing emergency admissions for asthma in hospital.

Asthma is a very common condition which affects more than five million people in the UK. Attacks can become life threatening so it is very important that patients with an asthma attack receive prompt treatment to prevent the disease deteriorating, which often results in patients needing hospital admission. Up to 90 per cent of deaths and 70 per cent of emergency admissions with asthma are associated with potentially preventable factors.

Our research team studied patient data for more than three million asthma sufferers across 7,806 surgeries in England (95 per cent of surgeries). We compared data from surgeries on emergency admissions for asthma with access to primary care as detailed in the GP Patient Survey – a sample of five million patients (10 per cent of the practice population). The team also looked at variables including the size of practice, whether the area was classed as deprived, the age, ethnicity and gender of the population, and the distance of the practice from the nearest hospital by road.
When looking at access to primary care, we used a composite measure which included seven measures of access,  including whether patients could get through on the phone, and whether patients were able to book appointments.

There were 55,570 asthma-related emergency admissions, and we found a strong link between poor access to care and higher amounts of admissions.Indeed, for every 10 per cent increase in access scores, there was a 32 per cent reduction in emergency admissions. This is an important finding because there is a significant risk of death for patients who have an emergency admission with asthma.

This research adds weight to the growing association between better access to primary care and lower rates of emergency admissions for a number of other conditions including heart failure, diabetes, stroke, cancer and epilepsy.Taking this report in context with other studies that have shown similar links, it appears that good access to primary care surgeries is associated with fewer hospital admissions.  Research has also identified a shortage of GPs over several years, and it is my view that access is likely to be improved by having more GPs [and perhaps more trained practice nurses] in surgeries. This hopefully will optimise the management of patients with asthma reducing the risk of acute attacks, and also lead to the treatment of attacks promptly and reducing the risk of hospital admission.

Emergency hospital admissions for asthma and access to primary care; cross-sectional analysis, is published in the British Journal of General Practice on June 21, 2016.


Dr Robert Fleetcroft
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