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Allergy/immunology inpatient consultations decreased over 23 years

There was a decreasing trend in allergy/immunology inpatient consultations from 1991 to 2013, with a significant decrease for asthma consults, according to recent study results.

“Allergy/immunology consultation is an important feature of the fellowship training and is a crucial service provided by the department,” researchers in the department of allergy and clinical immunology at Kaiser Permanente Southern California wrote.

The researchers reviewed medical records of 1,797 inpatient consultations (n=1,564 patients) from an allergy and clinical immunology clinic, which provided consultations to other inpatient services, at a tertiary care academic medical center during the study period.

There was a decrease in the number of consultations (P<.001). There was a slight increase, however, when compared with total hospitalizations, with the consultation service evaluating 0.07% of 242,470 hospitalized patients in 1991 vs. 0.1% of 69,084 patients in 2013 (P=.01).

Asthma (53%), drug allergy (21%) and immunodeficiency (9.7%) were the most common reasons for inpatient consultations. Asthma consultations declined from 130 of 173 consultations in 1991 to one of 71 consultations in 2013 (P<.001).

There was an increase in consultations for aspirin allergy, from one among 173 in 1991 to 23 out of 71 in 2013 (P<.001).

“The data revealed a decreasing trend for consultations, specifically for asthma,” the researchers reported. “This finding mirrors that of prior studies, which found a decrease in inpatient allergy consultations, especially for asthma.

“We hope that by measuring the patient problems encountered on our allergy/immunology consultation service and modifying our curriculum, the education of our fellows will improve, ultimately improving the care of our patients,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.