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Titolo:
Dedicated asthma center improves the quality of care and resource utilization for pediatric asthma: A multicenter study
Autore:
Battleman, DS; Callahan, MA; Silber, S; Munoz, CI; Santiago, L; Abularrage, J; Jabbar, H;
Indirizzi:
Cornell Univ, Weill Med Coll, New York Presbyterian Healthcare Syst, Dept Publ Hlth,Off Outcomes Res, New York, NY 10021 USA Cornell Univ New York NY USA 10021 f Outcomes Res, New York, NY 10021 USA Cornell Univ, Weill Med Coll, New York Presbyterian Healthcare Syst, Dept Internal Med, New York, NY 10021 USA Cornell Univ New York NY USA 10021 t Internal Med, New York, NY 10021 USA New York Methodist Hosp, Dept Emergency Med, Brooklyn, NY USA New York Methodist Hosp Brooklyn NY USA Emergency Med, Brooklyn, NY USA New York Hosp, Queens Med Ctr, Dept Pediat, Queens, NY USA New York Hosp Queens NY USA Queens Med Ctr, Dept Pediat, Queens, NY USA
Titolo Testata:
ACADEMIC EMERGENCY MEDICINE
fascicolo: 7, volume: 8, anno: 2001,
pagine: 709 - 715
SICI:
1069-6563(200107)8:7<709:DACITQ>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
INNER-CITY CHILDREN; RISK-FACTORS; CHILDHOOD ASTHMA; HOME; HOSPITALIZATION; EXACERBATIONS; PREVALENCE; MANAGEMENT; EMERGENCY; INDOOR;
Keywords:
pediatrics; asthma; asthma center; emergency department utilization;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Battleman, DS Cornell Univ, Weill Med Coll, New York Presbyterian Healthcare Syst, Dept Publ Hlth,Off Outcomes Res, 525 E 68th St,Box 73, New York, NY 10021 USA Cornell Univ 525 E 68th St,Box 73 New York NY USA 10021 USA
Citazione:
D.S. Battleman et al., "Dedicated asthma center improves the quality of care and resource utilization for pediatric asthma: A multicenter study", ACAD EM MED, 8(7), 2001, pp. 709-715

Abstract

Objectives: To determine the relative effectiveness of pediatric asthma care among patients treated by a dedicated asthma center (AC) vs children whouse the emergency department (ED) as a site of primary asthma care. Methods: A retrospective case-control design was used. A random sample of AC cases was selected from a designated comprehensive AC over a 12-month period. Concurrent ED control patients were identified from all cases of pediatric asthma from five urban hospitals based on two or more ED visits. Cases and controls were matched (1:2) based on age and National Heart, Lung, and BloodInstitute (NHLBI) asthma severity of illness classification. A telephone survey was administered to the caregivers of all enrolled patients in the study sample. Results: Four elements of pediatric asthma care were examined: quality, access, hospital utilization, and functional impact of disease. Demographic data were similar between the ED cases and the AC controls. In terms of quality of care, the AC patients were more likely to use maintenanceanti-inflammatory medications, 60.2% vs 22.5% (OR = 5.3; 95% CI = 2.9 to 9.7) and more likely to be taking medications at school, 71.4% vs 48.1% (OR = 2.7; 95% CI = 1.5 to 4.7). In terms of access to care, the AC families were more likely to have a physician to call to assist with outpatient management, 98.2% vs 65.0% (OR = 25.3; 95% CI = 9.0 to 76.9). Frequent ED utilization (greater than or equal to1 visit/month) was less likely in the AC patients, 9.2% vs 22.0% (OR = 0.35; 95% CI = 0.16 to 0.79) and school absenteeism was lower as well(9.5 +/- 6.7 days vs 16.6 +/- 10.3, p < 0.001). Additionally, the caregivers of the AC patients missed fewer workdays (4.7 <plus/minus> 2.8 vs 7.4 +/- 4.1; p = 0.03). Conclusions: Significant disparities in quality, access, resource utilization, and functional impact exist between AC and ED patients. Emergency physicians have a unique opportunity to improve the public health by directing ED patients toward pediatric AC treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 22:36:07