Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Michigan (cont'd)
Pediatric Asthma Disease Management
Hurley Medical Center
George Zureikat, MD
A pre/post study was done to investigate whether implementing an asthma disease management program that involved the interplay of a physician in an asthma clinic, and periodic home visits by non-physician members of this program, could reduce asthma morbidity in disadvantaged inner-city children with moderate to severe asthma in Flint, MI.
Participants were identified for acute asthma from inpatient pediatric floors at the time of admission. The asthma disease management team evaluated the homes of families of children with asthma for the presence of, and avoidance of, potential allergens. The team also provided continuous education and support to the child and family as part of comprehensive asthma management. The team worked together to conduct the initial and subsequent (every 3 months) home evaluations as well as child and family asthma education. The team was a continuous link between the child's family and a physician in the asthma clinic.
Records of 142 children (aged 6 ± 4 years) enrolled into the program for at least one year were reviewed. There was a significant reduction in the number of hospital admissions: 1.2 ± 0.11 (mean ± SEM) vs. 0.5 ± 0.1 episodes (p < 0.05), length of stay on pediatric floors: 3.2 ± 0.5 vs. 1.4 ± 0.38 days (p < 0.05) and in the pediatric critical care unit: 0.8 ± 0.2 vs. 0.2 ± 0.09 days (p < 0.05) 1 year after enrollment into the program. There was also a reduction in the proportion of the number of missed school days (35% vs. 12%, p < 0.01) and days with restricted activities (35% vs. 13%, p < 0.001) one year after enrollment into the program compared to the previous year.
The authors concluded that introduction of an asthma disease management program to disadvantaged inner-city children with moderate to severe asthma may reduce resource utilization and improve quality of life in this high-risk group of children with asthma.
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