Accessibility and health service utilisation for asthma in Norfolk, England

A. P. Jones*, G. Bentham, B. D.W. Harrison, D. Jarvis, R. M. Badminton, N. Wareham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


In the predominantly rural county of Norfolk, England, a confidential enquiry into asthma deaths found a recurrent issue is a poor understanding of the condition amongst sufferers, leading to delays in seeking care (Thorax 1993; 1117-20). Using the results of a questionnaire survey, we examined the relationship between accessibility and health service utilisation in a sample of young adults in Norfolk. The study was based on 9764 responses from the Norfolk Respiratory Health Survey. Amongst those, 591 reported having suffered an attack of asthma in the previous 12 months. Using logistic regression, the analysis concentrated on associations between the use of health services and their accessibility. Utilisation behaviour was found to be associated with respondents' smoking status, and the socio-economic characteristics of their neighbourhood. However, associations with measures of health service accessibility were also apparent. Respondents reporting asthma were less likely to have ever visited a GP if they lived outside a settlement containing a surgery (Odds ratio 3.07; p=0.03), and the likelihood of consultation declined with distance from a surgery (Odds ratio for a 1 kilometre increase in distance, 0.79; p < 0.01). Those living further from an acute hospital unit were also less likely to have consulted a hospital doctor in the previous 12 months (Odds ratio for a 1 kilometre increase in distance, 0.95; p = 0.01). Our finding of lower levels of health service utilisation amongst some self-reported asthmatics living further from health facilities suggests that the condition of certain individuals might be poorly treated, which could increase the risk of fatality.

Original languageEnglish
Pages (from-to)A29
Issue numberSUPPL. 3
Publication statusPublished - Dec 1996
Externally publishedYes


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