SETTING: Emergency Room of Alia Governmental hospital in Hebron district, south of West Bank, Palestine.

OBJECTIVE: To determine the factors associated with chronic asthma severity among asthma patients attending the emergency rooms in Palestine.

DESIGN: A cross-sectional study using previously validated questionnaires.

RESULTS: Among the 121 patients, 45.5% had moderate/severe asthma. Most days\\\' regular intake of oral theophylline, and using >or=5 courses/year of oral steroids were more likely to be associated with moderate/severe asthmatics (p<0.05). Moderate/severe asthmatics compared with mild asthmatics were more likely to use inhaled short B(2)-agonists more frequently (most days, 50% vs. 17%; p<0.05) and in higher concentrations (>or=1 cannister/month, 78% vs. 29%; p<0.05). They were also more likely to get regular treatment (p<0.05) and to report their inability to afford/obtain asthma medicines (p>0.05).

CONCLUSIONS: Access to health services doesn\\\'t necessarily ensure a good quality of care for asthmatics. The effectiveness of oral theophyline in controlling the more severe asthma symptoms should be reconsidered. We recommend a training program for health professionals and an educational one on self-management for the asthma patients.