Objectives: To determine whether an organized, citywide asthma management prog ram delivered by primary care providers (PCPs) increases adherence to the Nation al Asthma Education and Prevention Program (NAEPP) Asthma...Objectives: To determine whether an organized, citywide asthma management prog ram delivered by primary care providers (PCPs) increases adherence to the Nation al Asthma Education and Prevention Program (NAEPP) Asthma Guidelines and whether adherence to the guidelines by PCPs decreases medical services utilization in l ow-income, minority children. Study design: Analysis of the utilization of medi cal services for a cohort of 3748 children with asthma who presented for care at one of six primary care urban clinics in Hartford, Connecticut, and whowere enr olled in a disease management program (Easy BreathingTM) between June 1, 1998 an d August 31, 2002. Results: Of the 3748 children with physician confirmed asthma , 48%had persistent disease. Paid claims for inhaled corticosteroids increased 25%(P <.0001) after enrollment in Easy Breathing. Provider adherence to the NAE PP guidelines for anti-inflammatory therapy increased from 38%to 96%. Easy Br eathing children with asthma experienced a 35%decrease in overall hospitalizati on rates (P <.006), a 27%decrease in asthma emergency department (ED) visits (P <.01), and a 19%decrease in outpatient visits (P <.0001). Conclusions: An organ ized, disease management program increased adherence to the NAEPP guidelines for anti-inflammatory use by PCPs in urban clinics. Adherence to this element of t he guidelines by PCPs reduced hospitalizations, ED visits, and outpatient visits for children with asthma.展开更多
文摘Objectives: To determine whether an organized, citywide asthma management prog ram delivered by primary care providers (PCPs) increases adherence to the Nation al Asthma Education and Prevention Program (NAEPP) Asthma Guidelines and whether adherence to the guidelines by PCPs decreases medical services utilization in l ow-income, minority children. Study design: Analysis of the utilization of medi cal services for a cohort of 3748 children with asthma who presented for care at one of six primary care urban clinics in Hartford, Connecticut, and whowere enr olled in a disease management program (Easy BreathingTM) between June 1, 1998 an d August 31, 2002. Results: Of the 3748 children with physician confirmed asthma , 48%had persistent disease. Paid claims for inhaled corticosteroids increased 25%(P <.0001) after enrollment in Easy Breathing. Provider adherence to the NAE PP guidelines for anti-inflammatory therapy increased from 38%to 96%. Easy Br eathing children with asthma experienced a 35%decrease in overall hospitalizati on rates (P <.006), a 27%decrease in asthma emergency department (ED) visits (P <.01), and a 19%decrease in outpatient visits (P <.0001). Conclusions: An organ ized, disease management program increased adherence to the NAEPP guidelines for anti-inflammatory use by PCPs in urban clinics. Adherence to this element of t he guidelines by PCPs reduced hospitalizations, ED visits, and outpatient visits for children with asthma.
