ABSTRACT
OBJECTIVE: To assess the effect of a government funded asthma medication programme on paediatric (age < or = 12 years) asthma hospital admissions in Antigua and Barbuda. METHODS: A retrospective review of all hospital admissions for asthma in children was performed for the six years before and six years after a Medical Benefits Scheme (MBS) programme was established in 1997 to provide asthma medications at no out-of-pocket cost. Holberton Hospital records (1992 to 2003) which include all paediatric asthma admissions in Antigua and Barbuda, were reviewed RESULTS: Paediatric admissions for asthma fell from mean +/- standard deviation of 77.0 +/- 24.8 per year before the MBS programme was started to 48.0 +/- 17.1 per year (p < 0.05) after the MBS programme was started. The number of multiple admissions fell from 18.7 +/- 2.7 to 9.5 +/- 4.8 (p < 0.005) and the number of children admitted multiple times per year fell from 7.8 +/- 1.9 to 4.7 +/- 2.5 (p < 0.05). The number of children aged four to nine years admitted with asthma fell from 7.8 per 1000 annually during 1992 to 1997 to 4.4 per 1000 per year during 1998 to 2003. CONCLUSIONS: The government funded MBS programme for asthma medication has resulted in a 38% decrease in hospital admissions for paediatric asthma over a six-year period. The benefits of a similar programme in other developing countries should be considered.
Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Hospitalization/statistics & numerical data , National Health Programs/economics , Anti-Asthmatic Agents/economics , Antigua and Barbuda , Child , Child, Preschool , Developing Countries , Female , Humans , Male , Retrospective StudiesABSTRACT
Echocardiographic findings were reviewed for 106 patients (mean age 41.3 +/- 23.0 years, range 3 to 90 years, 61% female) referred for evaluation of unexplained syncope. Abnormal echocardiographic findings were seen in 36/106 (34%) patients, of which 12/106 (11%) may have an abnormality that contributed to symptoms. Abnormal echocardiographic findings (64 vs 6%, p < 0.01) and those possibly causing syncope (22 vs 0%, p < 0.05) were significantly more likely in the oldest tercile of patients compared with the youngest. No patient less than 35 years old had a possibly diagnostic abnormality.