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哮喘管理项目对哮喘患者的影响:在一家管理式医疗组织中进行的为期两年研究的以患者为中心的结果

Effects of an asthma management program on the asthmatic member: patient-centered results of a 2-year study in a managed care organization.

作者信息

Buchner D A, Butt L T, De Stefano A, Edgren B, Suarez A, Evans R M

机构信息

Schering-Plough, Kenilworth, NJ 07033, USA.

出版信息

Am J Manag Care. 1998 Sep;4(9):1288-97.

Abstract

OBJECTIVE

To report the results of a 2-year pilot program of asthma education based on National Heart, Lung, and Blood Institute treatment guidelines.

PATIENTS AND METHODS

Asthmatic members (n = 6698) of a managed care organization received education about their condition directly or through their primary care physician. Medical and pharmacy administrative claims data were reviewed to measure acute asthma events and prescribed therapies in the first (the baseline) and second years of the study. The claims data were augmented by member surveys from a stratified random sample of 2734 asthmatic patients who were members (6 years of age or older) in the baseline year.

RESULTS

Compared with the first year, asthmatic members received fewer inpatient services and the proportion of asthmatic members prescribed oral inhaled corticosteroids increased 30% in the second year. Health-related quality of life, measured with validated general and disease-specific instruments; satisfaction with the quality of care; exposure to patient education; knowledge of the disease; and member's confidence in their ability to manage their disease showed statistically significant improvements during the follow-up year of the program for both adult and child asthmatic members.

CONCLUSION

For asthmatic members of this health plan, a comprehensive asthma health management program improved processes of care and outcomes.

摘要

目的

报告一项基于美国国立心肺血液研究所治疗指南的为期两年的哮喘教育试点项目的结果。

患者与方法

一家管理式医疗组织的哮喘患者成员(n = 6698)直接或通过其初级保健医生接受了关于自身病情的教育。研究人员审查了医疗和药房管理索赔数据,以衡量研究第一年(基线)和第二年的急性哮喘事件及所开处方的治疗方法。通过对2734名哮喘患者(6岁及以上)进行分层随机抽样调查,对索赔数据进行补充,这些患者在基线年份为该组织成员。

结果

与第一年相比,哮喘患者成员接受的住院服务减少,第二年开具口服吸入性糖皮质激素的哮喘患者成员比例增加了30%。使用经过验证的通用和疾病特异性工具测量的健康相关生活质量;对医疗质量的满意度;接受患者教育的情况;对疾病的了解;以及成员对自身疾病管理能力的信心,在该项目的随访年度中,成年和儿童哮喘患者成员均显示出统计学上的显著改善。

结论

对于该健康计划的哮喘患者成员而言,一项全面的哮喘健康管理计划改善了护理流程和结果。

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