Community Asthma Initiative: Cost Analyses using Claims Data from a Medicaid Managed Care Organization

Bhaumik, Urmi; Sommer, Susan J.; Lockridge, Ryan; Penzias, Rebecca E.; Nethersole, Shari; Woods, Elizabeth R.

doi:10.1080/02770903.2019.1565825

Cited by 8 publications

(1 citation statement)

References 17 publications

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“…For example, previous studies have evaluated community health workers who provided psychosocial and educational support, care coordination, home environment assessment, and remediation. These interventions were reported to be cost-effective, as well as reduce ED visits, hospitalizations, patient missed school days, and parent missed workdays [ 39 – 41 ].…”

Section: Discussionmentioning

confidence: 99%

Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study

et al. 2022

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Background Having a primary care provider and a continuous relationship may be important for asthma outcomes. In this study, we sought to determine the association between 1) having a usual provider of primary care (UPC) and asthma-related emergency department (ED) visits and hospitalization in Québec children with asthma and 2) UPC continuity of care and asthma outcomes. Methods Population-based retrospective cohort study using Québec provincial health administrative data, including children 2-16 years old with asthma (N = 39, 341). Exposures and outcomes were measured from 2010-2011 and 2012-2013, respectively. Primary exposure was UPC stratified by the main primary care models in Quebec (team-based Family Medicine Groups, family physicians not in Family Medicine Groups, pediatricians, or no assigned UPC). For those with an assigned UPC the secondary exposure was continuity of care, measured by the UPC Index (high, medium, low). Four multivariate logistic regression models examined associations between exposures and outcomes (ED visits and hospitalizations). Results Overall, 17.4% of children had no assigned UPC. Compared to no assigned UPC, having a UPC was associated with decreased asthma-related ED visits (pediatrician Odds Ratio (OR): 0.80, 95% Confidence Interval (CI) [0.73, 0.88]; Family Medicine Groups OR: 0.84, 95% CI [0.75,0.93]; non-Family Medicine Groups OR: 0.92, 95% CI [0.83, 1.02]) and hospital admissions (pediatrician OR: 0.66, 95% CI [0.58, 0.75]; Family Medicine Groups OR: 0.82, 95% CI [0.72, 0.93]; non-Family Medicine Groups OR: 0.76, 95% CI [0.67, 0.87]). Children followed by a pediatrician were more likely to have high continuity of care. Continuity of care was not significantly associated with asthma-related ED visits. Compared to low continuity, medium and high continuity of care decreased asthma-related hospital admissions, but none of these associations were significant. Conclusion Having a UPC was associated with reduced asthma-related ED visits and hospital admissions. However, continuity of care was not significantly associated with outcomes. The current study provides ongoing evidence for the importance of primary care in children with asthma.

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Section: Discussionmentioning

confidence: 99%

Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study

et al. 2022

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Collaborative Integration of Community Health Workers in Hospitals and Health Centers to Reduce Pediatric Asthma Disparities: A Quality Improvement Program Evaluation

Basnet,

Wroblewski,

Hansen

et al. 2024

J Community Health

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To address pediatric asthma disparities on the South Side of Chicago, a community health worker (CHW) home visiting intervention was implemented collaboratively by academic institutions and community based health centers. This evaluation assessed the effectiveness of this longitudinal quality improvement CHW intervention in reducing asthma morbidity and healthcare utilization. All patients aged 2–18 who met the high-risk clinical criteria in outpatient settings or those who visited the ED due to asthma were offered the program. A within-subject study design analyzed asthma morbidity and healthcare utilization at baseline and follow-up. Multivariable mixed-effects regression models, adjusted for baseline demographic and asthma characteristics, were used to assess changes over time. Among 123 patients, the average age was 8.8 (4.4) years, and 89.3% were non-Hispanic black. Significant reductions were observed in the average daytime symptoms days (baseline 4.1 days and follow-up 1.6 days), night-time symptoms days (3.0 days and 1.2 days), and days requiring rescue medication (4.1 days and 1.6 days) in the past two weeks (all p < 0.001). The average number of emergency department visits decreased from 0.92 one year before to 0.44 one year after program participation, a 52% reduction (p < 0.001). No significant difference was found in hospital admissions. These results support the use of a collaborative approach to implement the CHW home visiting program as part of standard care for pediatric asthma patients in urban settings. This approach has the potential to reduce asthma disparities and underscores the valuable role of CHWs within the clinical care team.

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Adverse Childhood Experiences and Related Events are Associated with Asthma Symptoms in Children

Martinez,

Ye,

Hessler

et al. 2024

Academic Pediatrics

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Community Asthma Initiative: Cost Analyses using Claims Data from a Medicaid Managed Care Organization

Cited by 8 publications

References 17 publications

Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study

Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study

Collaborative Integration of Community Health Workers in Hospitals and Health Centers to Reduce Pediatric Asthma Disparities: A Quality Improvement Program Evaluation

Adverse Childhood Experiences and Related Events are Associated with Asthma Symptoms in Children

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