Abstract
Emergency care and hospitalizations account for 36% of asthma-related medical expenses for children. National asthma guidelines emphasize the need for asthma self-management education at multiple points of care, including the hospital, to help prevent acute exacerbations. The integration of a bedside asthma education program into discharge planning at a busy urban children’s hospital aimed to reduce repeat emergency department (ED) visits and hospitalizations by educating the community’s highest-risk children and their families about asthma. A trained respiratory professional provided 45 minutes of individualized bedside education to families at the hospital and one follow-up support phone call within 3 weeks after discharge. Children receiving the intervention were matched to a control group of children not receiving the intervention by age and 2 markers of past utilization using data obtained from hospital records. Repeat ED utilization was analyzed using a Cox proportional hazards model controlling for sex, residence, race or ethnicity, and year. Compared to 698 matched controls, no significant improvement was observed in the 698 intervention participants or any subgroups followed for 12 months after the intervention.
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Notes
Detailed statistical methodology is available upon request.
Anyone who did not have a follow-up visit within 365 days was “right censored.”
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Acknowledgments
This project was supported in large part through a cooperative agreement with the Centers for Disease Control and Prevention U.S. Department of Health and Human Services, under program announcement 03030. Additional support came from First 5 Alameda County, the West Oakland Asthma Coalition, and Children’s Hospital Oakland and Research Center.
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Davis, A.M., Benson, M., Cooney, D. et al. A Matched-Cohort Evaluation of a Bedside Asthma Intervention for Patients Hospitalized at a Large Urban Children’s Hospital. J Urban Health 88 (Suppl 1), 49–60 (2011). https://doi.org/10.1007/s11524-010-9517-6
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DOI: https://doi.org/10.1007/s11524-010-9517-6