Hospital admissions for asthma in east london: associations with characteristics of local general practices, prescribing, and population

Abstract Objective: To determine the relative importance of appropriate prescribing for asthma in explaining high rates of hospital admission for asthma among east London general practices. Design: Poisson regression analysis describing relation of each general practice's admission rates for asthma with prescribing for asthma and characteristics of general practitioners, practices, and practice populations. Setting: East London, a deprived inner city area with high admission rates for asthma. Subjects: All 163 general practices in East London and the City Health Authority (complete data available for 124 practices). Main outcome measures: Admission rates for asthma, excluding readmissions, for ages 5-64 years; ratio of asthma prophylaxis to bronchodilator prescribing; selected characteristics of general practitioners, practices, and practice populations. Results: Median admission rate for asthma was 0.9 (range 0-3.6) per 1000 patients per year. Higher admission rates were most strongly associated with small size of practice partnership: admission rates of singlehanded and two partner practices were higher than those of practices with three or more principals by 1.7 times (95% confidence interval 1.4 to 2.0, P