Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Florida (cont'd)
Influence of an Interventional Program on Resource Use and Cost in Pediatric Asthma
Naval Hospital Jacksonville
James C. Higgins DO, CDR MC USN
The objective of this prospective pilot study was to determine whether patient education and assignment to a primary care provider improve outcomes and cost in the management of pediatric asthma. The study was conducted with a retrospective review of health and pharmacy records.
Sixty-one unassigned pediatric asthma patients who were noted to be frequent users of emergency department services and who had no primary care provider were identified. This cohort received asthma education and was assigned a provider trained in the national asthma guidelines.
Hospital admissions, Emergency Department and clinic visits, use of beta 2 agonists and anti-inflammatory drugs, number of chest radiographs, and continuity of care were recorded for a mean of 58.1 months before and 11.2 months after the intervention. A cost analysis was done.
All measured parameters showed favorable changes after intervention, with the decrease in the number of prescriptions of monthly inhaled anti-inflammatory drugs and chest radiographs ordered being statistically significant (P = 0.007 and P = 0.040, respectively). Monthly admissions, Emergency Department visits, and clinic visits declined after intervention when evaluated after 22.8 months of follow up. Annual resource savings after intervention was estimated to be $4845.29 per patient for this military hospital.
In conclusion a combined intervention consisting of provider and patient education and assignment to a primary care provider was associated with improved care and economic outcomes in this group.
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