Asthma Home Care Cuts Kids' Hospital Visits

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When families who have kids with asthma are provided with patient-centered home care, the number of hospital visits to the emergency department and for hospitalization drop dramatically. Along with the decline in hospital visits is a decrease in health care costs.

Results of this “asthma medical home” approach project were presented at the Pediatric Academic Societies annual meeting in Vancouver, British Columbia. The study itself took place at Children’s Hospital Boston, where asthma is the number one reason for hospital admissions.

According to a study by the National Center for Health Statistics, 2006, 8.9 percent of children in the United States currently have asthma, and 9 million children younger than 18 have been diagnosed with asthma at some point in their lifetime. Nearly 4 million children experience an asthma attack in a given year.

Research estimates from 2005-2007 indicate that the prevalence of asthma is 9.4 percent among non-Hispanic black children, 7.7 percent among non-Hispanic white children, and 15.6 percent among Puerto Rican children. Compared with the general population, children from low-income families, minorities, and those living in inner cities experience more emergency department visits, hospitalizations, and deaths associated with asthma.

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In the Children’s Hospital Boston study, the authors identified 1,900 patient families with asthma and provided them with educational sessions that explained basics of asthma, appropriate use of medication, how to recognize and manage asthma attacks, and common environmental triggers for asthma.

The families also received referrals to specialists in allergy and pulmonary medicine, help in reducing exposure to environmental triggers (e.g., home visits to identify and remediate asthma triggers, access to dust mite covers), and assistance in obtaining asthma medications.

Compared with the year before the program was initiated, the number of emergency department visits for asthma-related reasons declined by 63 percent (from 26% in 2006 to 9.9 percent in 2009), and inpatient hospitalization rates dropped 62 percent (from 10.5% to 4%).

The number of hospital visits by kids with asthma was dramatic in this study. Children’s Hospital Boston asthma home care program showed that when families are offered information about their child’s asthma and how they can have more control over environmental triggers and other factors, they “are better empowered to manage their children’s asthma symptoms,” noted Faye F. Holder-Niles, MD, MPH, the study’s lead author.

SOURCES:
Centers for Disease Control and Prevention
National Center for Health Statistics
Lieu TA et al. Pediatrics 2002; 109:857-65
Pediatric Academic Societies
Weiss KB et al. Journal of Allergy Clinical Immunology 2000; 106:493-99

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