Use of asthma guidelines by primary care providers to reduce hospitalizations and emergency department visits in poor, minority, urban children

Michelle M. Cloutier, Charles B. Hall, Dorothy B. Wakefield, Howard Bailit

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

Objectives: To determine whether an organized, citywide asthma management program delivered by primary care providers (PCPs) increases adherence to the National Asthma Education and Prevention Program (NAEPP) Asthma Guidelines and whether adherence to the guidelines by PCPs decreases medical services utilization in low-income, minority children. Study design: Analysis of the utilization of medical services for a cohort of 3748 children with asthma who presented for care at one of six primary care urban clinics in Hartford, Connecticut, and who were enrolled in a disease management program (Easy Breathing™) between June 1, 1998 and August 31, 2002. Results: Of the 3748 children with physician-confirmed asthma, 48% had persistent disease. Paid claims for inhaled corticosteroids increased 25% (P <.0001) after enrollment in Easy Breathing. Provider adherence to the NAEPP guidelines for anti-inflammatory therapy increased from 38% to 96%. Easy Breathing children with asthma experienced a 35% decrease in overall hospitalization rates (P <.006), a 27% decrease in asthma emergency department (ED) visits (P <.01), and a 19% decrease in outpatient visits (P <.0001). Conclusions: An organized, disease management program increased adherence to the NAEPP guidelines for anti-inflammatory use by PCPs in urban clinics. Adherence to this element of the guidelines by PCPs reduced hospitalizations, ED visits, and outpatient visits for children with asthma.

Original languageEnglish (US)
Pages (from-to)591-597
Number of pages7
JournalJournal of Pediatrics
Volume146
Issue number5
DOIs
StatePublished - May 2005
Externally publishedYes

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Hospital Emergency Service
Primary Health Care
Hospitalization
Asthma
Guidelines
Respiration
Disease Management
Education
Anti-Inflammatory Agents
Outpatients
Guideline Adherence
Adrenal Cortex Hormones
Physicians

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Use of asthma guidelines by primary care providers to reduce hospitalizations and emergency department visits in poor, minority, urban children. / Cloutier, Michelle M.; Hall, Charles B.; Wakefield, Dorothy B.; Bailit, Howard.

In: Journal of Pediatrics, Vol. 146, No. 5, 05.2005, p. 591-597.

Research output: Contribution to journalArticle

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