Differences in Asthma Care Between the US and UK

I recently had the opportunity to join a support group for people with severe asthma. The group is based out of the UK, but they were gracious enough to let me join from the states.

I thoroughly enjoyed speaking with and spending time with a group of people who really understand my struggles. The conversation was uplifting and encouraging, and I even learned a few things along the way.

During the group, it struck me just how different treatment of asthma is between the US and the UK. While some things like treatments and hospital stays are a staple on both sides of the ocean, there were some significant differences that really stood out to me.

Differences in care for asthma

Nebulizers

While we were chatting, someone mentioned that they were frustrated that they did not have a nebulizer at home to help once they were discharged from the hospital. Someone else commented that they had special permission from their doctor to have a nebulizer at home to use until they could call an ambulance. Both of these statements sounded a bit odd to me so I jumped into the conversation. “So you guys don’t have nebulizers at home?” I asked.

The leader of the group quickly answered my question and said that no, unfortunately, it is rare for people with asthma to have a nebulizer at home. According to her, the UK reported more asthma deaths when people had nebulizers at home because patients were relying on the nebulizer medicine for relief instead of heading to the hospital when they had a significant exacerbation. I suppose their reasoning is if people do not have a nebulizer at home, they will be forced to seek out treatment in an emergency setting, therefore leading to better outcomes.

Of course, there are exceptions to this rule, especially for people with severe asthma. While I am glad that some people are able to have access to it outside of a hospital, it makes me wonder how much additional stress is being placed on the health system. I know for me personally, my nebulizer has kept me out of the hospital many times, and has allowed me to be discharged from the hospital because it means I have the tools I need to take care of my asthma at home.

But that brings me to the next BIG difference in how asthma is managed.

Hospital stays

I have been hospitalized many times for my asthma. I think my longest admission was 5 days. But many of the people in the support group said that they had admissions of 10 days or longer.

In hearing the group members speak about their experiences, it seems like the health system in the UK keeps patients in the hospital until they are confident the patient had recovered and will do well when they get home. That is such a striking difference from the system I have experienced where they try to discharge you just as soon as they think you can, ready or not.

I worked at a large university hospital for many years. One of the departments in my office was in charge of determining bed assignments for each patient. The focus was on discharging patients as soon as possible so that the bed could be filled by someone else. So I was floored when one of the group members of the support group said that she had to convince the doctors to discharge her from the hospital.

Instead of being forced out of the hospital as soon as possible, the roles almost seem reversed. In one system (the US) the goal seems to be to get you in and out as quickly as possible, while the other system (the UK) seems to keep the patient, almost to a fault, until they think the patient is healthy and ready to go home.

More to learn

These are just 2 differences I noticed during our short conversation. I know there are many other differences too. I have always known that our health systems are very different, but it was very striking to hear them discussed from the viewpoint of severe asthma.

I’m really looking forward to more conversations with this support group and know that there is a lot more I can learn from these new friends.