Please allow me to comment on the article concerning severity of asthma in the March issue of the Archives.1 There is a statement in the abstract, "Patients in the... groups had similar histories of home medication use," that does not ring true. The study's main point is that the long-stay patients received less medicine per hour during antecedent illness than the short-stay group. Also, the authors state that four patients had "psychosocial problems" in the long-stay contingent; it is unclear whether there was simply a logistical detainment after rapid response or the problems contributed to disease severity as a variable.
I want to point out that this disease may serve to highlight a great threat from Managed Care. As we all know, the rate of deaths due to asthma has been rising. Many of these deaths are still mysterious; there is some correlation with inhaler use. I think that
Needles CF. Factors Associated With Prolonged Hospitalization of Children With Asthma. Arch Pediatr Adolesc Med. 1995;149(12):1401. doi:10.1001/archpedi.1995.02170250107023