Background:

At present,asthma represents a substantial burden on health care resources especially in developing countries.It is important to understand the potential barriers to medical care that challenge vulnerable populations.

Aim:

To identify indicators of medical care access among asthma-related hospitalized patients in pulmonology department of mongi slim hospital.

Methods:

A retrospective study included patients with asthma,who were admitted for exacerbation ;during the period from 2018 to 2022.Patients were divided into two groups:G1:patients with insurance coverage,G0:patients without insurance coverage.

Results:

The study included 113 patients,with an estimated sex ratio (male/female) of 1,77.The mean age was 44.5±15.1 years.The median age of onset of asthma was 27±12.3years.Most patients(65,3%) were treated in primary care medicine only and have never visited a specialist;and 11.4% never consulted after diagnosis.Only 26.2% of them had pulmonary function tests and skin tests.G1 represented 59,3%(n=67)and G0 represented 40.7%(n=46).Patients in G0 had more uncontrolled asthma(52.3%vs22.1%;p=0.002).A regular treatment with inhaled corticosteroids is found in 76.8% of patients of G1 vs 21.3% of patients of G0(p=0.001).Exacerbations and emergency visits was more frequent in G0 (7.13vs2.33,p=0.001).Hospital stay was longer in G0 (10 days vs 5 days;p=0.03).Oral corticosteroids are most commonly used in patients of G0(23.1% vs 0%;p=0.001).Patients of G0 were more likely to have depression and anxiety compared with those of G1 (mean HAD score was 13 in G0 vs 8 in G1;p=0.05).

Conclusion:

Gaps in health insurance coverage and medical care access may complicate asthma management and increase emergency department use and hospitalization.