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Titolo:
Impact of a multidisciplinary day program on disease and healthcare costs in children and adolescents with severe asthma: A two-year follow-up study
Autore:
Bratton, DL; Price, M; Gavin, L; Glenn, K; Brenner, M; Gelfand, EW; Klinnert, MD;
Indirizzi:
Natl Jewish Med & Res Ctr, Dept Pediat, Denver, CO 80206 USA Natl Jewish Med & Res Ctr Denver CO USA 80206 ediat, Denver, CO 80206 USA Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA Univ Colorado Denver COUSA 80202 ado, Hlth Sci Ctr, Denver, CO 80202 USA
Titolo Testata:
PEDIATRIC PULMONOLOGY
fascicolo: 3, volume: 31, anno: 2001,
pagine: 177 - 189
SICI:
8755-6863(200103)31:3<177:IOAMDP>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
INNER-CITY CHILDREN; QUALITY-OF-LIFE; PSYCHOSOCIAL CHARACTERISTICS; TERM HOSPITALIZATION; ECONOMIC-EVALUATION; PEDIATRIC ASTHMA; CHILDHOOD ASTHMA; SELF-MANAGEMENT; REHABILITATION; EMERGENCY;
Keywords:
multidisciplinary program; asthma, outcomes; healthcare costs; children;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Bratton, DL Natl Jewish Med & Res Ctr, Dept Pediat, 1400 Jackson St, Denver, CO 80206 USA Natl Jewish Med & Res Ctr 1400 Jackson St Denver CO USA 80206
Citazione:
D.L. Bratton et al., "Impact of a multidisciplinary day program on disease and healthcare costs in children and adolescents with severe asthma: A two-year follow-up study", PEDIAT PULM, 31(3), 2001, pp. 177-189

Abstract

For patients whose asthma remains in poor control necessitating high utilization of medical services, a referral to a specialized "center of excellence" is often considered. A decade ago, we evaluated our pediatric asthma program of long-term hospitalization (median stay of 75 days) and found significant decreases in subjects' medical utilization following this intervention. In an effort to contain treatment costs, the former program was markedly altered to one of abbreviated stay with emphasis on family management of asthma. The purpose of the present study was to determine the outcome of children treated in the revised program with regard to disease severity, quality of life, and subsequent utilization of medical resources. Children withsevere asthma who were admitted to the program and fulfilled study criteria were consecutively enrolled. Data was obtained concerning disease characteristics, treatment, and quality of life at admission, and at I and 2 yearsfollowing discharge. Medical records for the year prior to program admission and for the 2 years following discharge were coded for medical care encounters. Ninety-eight children, aged 9 months to 18 years (mean age, 10.9 years), were enrolled. They participated in the program for a mean of 15.6 (+/-8 SD), median of 15.0, and range of 2-51 treatment days. The group showed significant improvement (P < 0.0001) from admission to 1- and 2-year follow-up inmedian corticosteroid use, asthma functional severity, perceived competence in asthma management, and quality of life for both caregiver and child. Medical record data showed significant improvement (P < 0.0001) at both 1- and 2-year follow-up in median number of corticosteroid bursts, emergency department visits, hospital days, and overall utilization of medical care encounters. A median total medical encounter cost/patient of $16,250 ($6,972-$25,714 interquartile range (IQR)) for the year prior to program participation was reduced to $1,902 ($505-$6,524 IQR) at I-year and $690 ($185-$3,550 IQR) at 2- year follow-up (P < 0.0001). We conclude that multidisciplinary care in a short-term, outpatient, day treatment program can significantly contribute to improvement in asthma severity, quality of life, and reduction in healthcare costs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 09:00:24