Asthma guideline use by pediatricians in private practices and asthma morbidity

Michelle M. Cloutier, Dorothy B. Wakefield, Pamela Sangeloty-Higgins, Steven Delaronde, Charles B. Hall

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

OBJECTIVE. We sought to examine whether pediatric clinicians in private, non-health maintenance organization practices could implement the national asthma guidelines and whether, when implemented, these guidelines would decrease medical services utilization and improve asthma care for children. METHODS. A trial of a disease management program (Easy Breathing II) involving 20 private pediatric practices in the greater Hartford, Connecticut area was conducted between January 1, 2001, and December 31, 2003. Demographic data on participating practitioners and patients were obtained from questionnaires. Medical services utilization data from claims were obtained from ConnectiCare, a regional managed care organization. RESULTS. Of the 16 750 children enrolled in Easy Breathing II, 2458 were enrolled in ConnectiCare and 490 had asthma. Inhaled corticosteroid use increased in the community overall during the study period. After enrollment in Easy Breathing II, with adjustment for age, gender, ethnicity, asthma severity, season, and calendar year, children with persistent asthma experienced an additional 47% increase in inhaled corticosteroid use, a 56% reduction in outpatient visits, and a 91% decrease in emergency department visits for treatment of asthma. Adherence to national asthma guidelines for prescribing inhaled corticosteroids was 95%. Seventeen of the 20 practices are still using Easy Breathing, 5 years after program implementation. CONCLUSIONS. Pediatric primary care clinicians in private practice settings can implement an asthma management program patterned after the national asthma guidelines. When implemented, this program is successful in reducing medical services utilization for children with asthma. Just as differences in patterns of medical services utilization exist in private practices, compared with urban clinics, the impact of disease management on medical services utilization differs in private practices, compared with urban clinics.

Original languageEnglish (US)
Pages (from-to)1880-1887
Number of pages8
JournalPediatrics
Volume118
Issue number5
DOIs
StatePublished - Nov 2006

Fingerprint

Private Practice
Asthma
Guidelines
Morbidity
Respiration
Adrenal Cortex Hormones
Pediatrics
Disease Management
Pediatricians
Organizations
Managed Care Programs
Child Care
Hospital Emergency Service
Primary Health Care
Outpatients
Demography

Keywords

  • Children
  • Claims data
  • Disease management
  • Easy breathing
  • Medical services utilization
  • National asthma education and prevention program

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Cloutier, M. M., Wakefield, D. B., Sangeloty-Higgins, P., Delaronde, S., & Hall, C. B. (2006). Asthma guideline use by pediatricians in private practices and asthma morbidity. Pediatrics, 118(5), 1880-1887. https://doi.org/10.1542/peds.2006-1019

Asthma guideline use by pediatricians in private practices and asthma morbidity. / Cloutier, Michelle M.; Wakefield, Dorothy B.; Sangeloty-Higgins, Pamela; Delaronde, Steven; Hall, Charles B.

In: Pediatrics, Vol. 118, No. 5, 11.2006, p. 1880-1887.

Research output: Contribution to journalArticle

Cloutier, MM, Wakefield, DB, Sangeloty-Higgins, P, Delaronde, S & Hall, CB 2006, 'Asthma guideline use by pediatricians in private practices and asthma morbidity', Pediatrics, vol. 118, no. 5, pp. 1880-1887. https://doi.org/10.1542/peds.2006-1019
Cloutier MM, Wakefield DB, Sangeloty-Higgins P, Delaronde S, Hall CB. Asthma guideline use by pediatricians in private practices and asthma morbidity. Pediatrics. 2006 Nov;118(5):1880-1887. https://doi.org/10.1542/peds.2006-1019
Cloutier, Michelle M. ; Wakefield, Dorothy B. ; Sangeloty-Higgins, Pamela ; Delaronde, Steven ; Hall, Charles B. / Asthma guideline use by pediatricians in private practices and asthma morbidity. In: Pediatrics. 2006 ; Vol. 118, No. 5. pp. 1880-1887.
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