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Asthma patients prefer treatment in the emergency department asthma observation unit to being hospitalized

Patients who arrive at the emergency department (ED) suffering from an acute asthma episode are more satisfied with their care if they remain for 12 hours in the ED-based asthma observation unit (AOU) than if they are admitted to the hospital from the ED, finds a new study. The researchers, supported by the Agency for Health Care Policy and Research (HS07103), studied asthma patients, who arrived at the ED over a 30-month period and who met criteria for hospital admission after 3 hours of standard ED asthma therapy (163 patients). They randomized 81 patients to receive AOU care and 82 patients to routine hospital admission.

The patients in the AOU group scored higher after diagnosis and treatment than those in the inpatient group on all seven care satisfaction measures. Their satisfaction was significantly greater for four measures: received service wanted, would recommend the service to others, were satisfied with the service, and were satisfied overall with their care. AOU patients also reported fewer total problems with care and fewer problems with communication, emotional support, physical comfort, and special needs than patients in the hospitalized group.

It seems that ED-based diagnostic and treatment units can provide acute asthma patients with care that is equal to but apparently more satisfying than traditional hospital care, concludes Robert J. Rydman, Ph.D., Cook County Hospital and the University of Illinois at Chicago. Their companion study also revealed that AOU patients had superior quality of life 7 days after discharge, equivalent rates of relapse necessitating emergency or primary care 8 weeks later, and lower costs by remaining in the ED for their acute episodes.

See "Patient satisfaction with an emergency department asthma observation unit," by Dr. Rydman, Rebecca R. Roberts, M.D., Gary L. Albrecht, Ph.D., and others, in the March 1999 Academic Emergency Medicine 6(3), pp. 178-183.

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