Improved Asthma Outcomes in a High-Morbidity Pediatric Population

Abstract

Attendance in the follow-up clinic was high. The intervention decreased subsequent unscheduled health care use while improving compliance and quality of life.

Low Rates of Follow-Up With Primary Care Providers After Pediatric Emergency Department Visits for Respiratory Tract Illnesses

“…Of note, several medical centers across the country have studied strategies to improve adherence to follow-up visits with primary care after ED visits for asthma through interventions such as monetary compensation, prescheduled follow-up appointments and phone call reminders for follow-up, 6,13,15,17,29 case management assistance, 14 and a unique transitional outpatient asthma follow-up program located in the ED itself. 30 Although most of these interventions demonstrate heightened short-term linkage between acute and primary care settings, they require substantial resources and have limited positive effects on long-term outcomes. 13,17,31 With economic forces attempting to shift care away from the acute care setting and into the medical home, the results of this study are timely and relevant.…”

Follow-Up After Acute Asthma Episodes: What Improves Future Outcomes?

“…In addition, the intervention group experienced cost savings of $2,220 per patient (P ϭ .03). Similarly, Teach et al (21) showed that a visit to an ED-based, specialized asthma follow-up clinic could improve several types of outcomes in a high-morbidity pediatric population. A multidimensional approach (see Table 1) led to fewer unscheduled visits, improved controller use, and improved quality of life in the intervention group.…”

Follow-up after acute asthma episodes: What improves future outcomes?

“…In addition, the intervention group experienced cost savings of $2,220 per patient (P 5 .03). Similarly, Teach et al 21 showed that a visit to an ED-based, specialized asthma followup clinic could improve several types of outcomes in a high-morbidity pediatric population. A multidimensional approach (see Table I) led to fewer unscheduled visits, improved controller use, and improved quality of life in the intervention group.…”

“…[19][20][21] Outcomes evaluated in all 3 studies were also comprehensive, including medical utilization and quality-of-life parameters. The intervention in the study by Castro et al 19 used a multifaceted approach consisting of 7 key elements: (1) nurse's suggestion of simplification or consolidation of the patient's medical regimen to the primary physician (based on National Asthma Education and Prevention Program II guidance); (2) daily completion of an asthma care flow sheet; (3) asthma education in accordance with patient education, cultural beliefs, and motivation; (4) psychosocial support and screening for professional counseling; (5) individualized asthma self-management plans; (6) social service professional consultations for discharge planning facilitation; and (7) outpatient follow-up through telephone contact, home visits, and follow-up appointments with the primary care physician.…”