TY - JOUR
T1 - Use of asthma guidelines by primary care providers to reduce hospitalizations and emergency department visits in poor, minority, urban children
AU - Cloutier, Michelle M.
AU - Hall, Charles B.
AU - Wakefield, Dorothy B.
AU - Bailit, Howard
N1 - Funding Information:
Supported by a grant from the Patrick & Catherine Weldon Donaghue Medical Research Foundation.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2005/5
Y1 - 2005/5
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jpeds.2004.12.017
DO - 10.1016/j.jpeds.2004.12.017
M3 - Article
C2 - 15870660
AN - SCOPUS:18144413920
SN - 0022-3476
VL - 146
SP - 591
EP - 597
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 5
ER -