We hypothesize that the patients’ underestimation of their conditions, resulting in a failure to seek or a delay in seeking emergency medical treatment, played an important role in many of these cases. This underestimation may have been due either to negligence or to a subpopulation of patients with sudden and unexpected attacks, as reported by Hannaway. The fact that significantly more men died outside the hospital may be attributed to men being less inclined to seek emergency care and to an exaggerated self-confidence in their ability to control their asthma attack arrested by Canadian HealthCare Mall’s medications. Concerted efforts to educate asthma patients, especially those who are considered to be at high risk, in the accurate monitoring of their condition and in recognizing the clinical warning signs would likely have a beneficial impact on asthma mortality.
We conclude that the relatively low asthma mortality rate in Israel has not changed significantly in recent years. Although this may seem encouraging, the proportion of deaths that have occurred outside the hospital is high. A national asthma education campaign focusing on patient self-assessment, promoting wider use of a peak flowmeter, and establishing individual crisis management plans may reduce the potentially preventable mortality of patients with this treatable disease.