Abstract
The access barriers to asthma basic treatment and medical care in many countries are an urgent problem and emphasize the need for population studies to examine the associated risk factors for barriers to health care, causes of severe exacerbations, disruption of life quality, and the development of preventive measures. The purpose of study was to evaluate the association of quality of life, access to medical care and emergency of severe exacerbation in persons with bronchial asthma in the Republic of Kazakhstan. The cross-sectional study was applied. The sample included 3,572 patients of both genders aged 18-59 years with bronchial asthma, registered in out-patient clinics of the Republic of Kazakhstan. The assessment of frequency of severe exacerbation in patients with asthma, depending on availability of medical care, demonstrated significant differences in groups of minimal, average and maximum decrease (χ2 = 160.66, 2057.06, 166.19, p<0.001). The most of patients in group with severe asthma exacerbations more than 3 times per year had signs of a maximum decrease in access to medical care - 53.5% and 42.11% were classified as a medium-level barrier of access. The indicator of quality of life was significantly lower in group of patients with severe exacerbation of disease more than 3 times per year in groups with severe access barriers as compared to group with similar number of exacerbations where the number of barriers was less than two - 10.85 vs. 15, 28 (t = 3.985, D.f. = 1, p = 0.003). The study permitted to conclude that improving quality and increasing availability of medical care of asthmatic patient is the key to managing course of asthma at stage of diagnosis and during treatment as well.