Impact of a comprehensive asthma program on pediatric inpatient admissions

Abstract

Rationale Children's Medical Center of Dallas developed an inpatient multidisciplinary asthma class in 1997 that alone, was insufficient to significantly reduce asthma-related re-hospitalizations. Subsequently, a comprehensive outpatient Asthma Management Program was implemented in 2001. Elements of the program include in-home education, multidisciplinary asthma class, telephonic follow-up, and care coordination. The program was designed to measure the intervention's impact on healthcare utilization and quality of life indicators. Methods Patients were identified by community physician and insurance provider referrals, as well as internal utilization reports. Eligibility criteria include residence in a five county radius, ages 0-17, and diagnosis of asthma. Pre-enrollment and enrollment period data were available for 45 participants who completed the program. Six-month post-completion data were available for 13 participants. Results Inpatient utilization for pre-enrollment, enrollment period and post-enrollment period were compared. The asthma related Inpatient admissions significantly declined from pre-enrollment (median 0.5) through course of enrollment (median 0.02) (p<.001). Analysis of post-enrollment period suggests that this decrease in inpatient utilization is sustained but the small number of patients limits the generalization of these results. Conclusions The comprehensive intervention decreased asthma-related inpatient admissions during the six-month program. Preliminary evidence supports sustained decreased levels of utilization for six months following participation.