ABSTRACT
BACKGROUND: Asthma bronchiale is a chronic disease with increasing prevalence, increasing numbers of hospital admissions, and a growing mortality rate. Training courses for patients could reduce the number of in-patients, but it is still not clear what leads to an increase in admissions and whether all children have equal access to the special training courses offered. METHODS: In order to settle these questions, 40 in-patients with asthma (clinical group) were compared with a training group of 80 children of the same age, who participated in an out-patients' training course for asthmatics held at Asthma-Zentrum Rhein-Main. During a retrospective examination clinical characteristics (therapy prior to admission, number of times of seeing a doctor before admission, number of days of absence from school) and socio-economic conditions (size of flat, level of education of parents, proportion of children from families of non-German origin), as well as environmental factors (parents' tobacco smoking) were determined. FINDINGS: As expected, significant disadvantages regarding clinical characteristics and socioeconomic data were recorded for the clinical group. Children in the clinical group less often got a regular prophylactic treatment before admission to hospital (43% vs. 80%). They were absent from school three times more often than children from the training group (6 days vs. 2 days); proportionally, their parents smoked twice as often (53% vs. 23%); frequently, the number of persons living in the flat exceeded the total number of rooms (43% vs. 23%), and only 61% had their own bedroom (vs. 81% in the training group). 40% of the children in the clinical group are from families of nationalities other than German vs. only 14% in the training group. Moreover, most parents of the children in the clinical group were undereducated or had no professional training at all, and rarely held university degrees. INTERPRETATION: The results show that the patients' profiles regarding therapy and socio-economic conditions differ substantially between in-patients and children from the training group at the Asthma-Zentrum. A major part of these patients in question had no access to or could not be reached by an ambulant training course for asthmatics. Especially socially and economically disadvantaged families, and families with little compliance must be informed more carefully and should be persuaded of the benefits of ambulant training courses for asthmatics.
