Kelly C S, Morrow A L, Shults J, Nakas N, Strope G L, Adelman R D
Division of Pulmonary, Allergy and Immunology, Eastern Virginia MedicalSchool, Norfolk, VA, USA.
Pediatrics. 2000 May;105(5):1029-35. doi: 10.1542/peds.105.5.1029.
To evaluate health care and financial outcomes in a population of Medicaid-insured asthmatic children after a comprehensive asthma intervention program.
Controlled clinical trial.
Pediatric allergy clinic in an urban, tertiary care children's hospital.
Eighty children, 2 to 16 years old, with a history of frequent use of emergent health care services for asthma. Intervention. Children in the intervention group received asthma education and medical treatment in the setting of a tertiary care pediatric allergy clinic. An asthma outreach nurse maintained monthly contact with the families enrolled in the intervention group.
Emergency department (ED) visits, hospitalizations, and health care charges per patient in the year after enrollment.
Baseline demographics did not differ significantly between the 2 groups. In the year before the study, there were no significant differences between intervention and control children in ED visits (mean, 3.5 per patient), hospitalizations (mean,.6 per patient) or health care charges ($2969 per patient). During the study year, ED visits decreased to a mean of 1.7 per patient in the intervention group and 2.4 in controls, while hospitalizations decreased to a mean of.2 per patient in the intervention group and.5 in the controls. Average asthma health care charges decreased by $721/child/year in the intervention group and by $178/patient/year in the control group.
A comprehensive asthma intervention program for Medicaid-insured asthmatic children can significantly improve health outcomes while reducing health care costs.asthma education, health care outcomes, Medicaid, asthma outreach, utilization.
评估在一项综合性哮喘干预项目实施后，医疗补助保险覆盖的哮喘儿童群体的医疗保健及财务结果。
对照临床试验。
一家城市三级护理儿童医院的儿科过敏诊所。
80名2至16岁有频繁因哮喘使用紧急医疗服务病史的儿童。干预措施：干预组儿童在三级护理儿科过敏诊所接受哮喘教育及治疗。一名哮喘外展护士与干预组登记的家庭保持每月联系。
入组后一年中每位患者的急诊就诊次数、住院次数及医疗保健费用。
两组的基线人口统计学特征无显著差异。在研究前一年，干预组和对照组儿童在急诊就诊次数（平均每位患者3.5次）、住院次数（平均每位患者0.6次）或医疗保健费用（每位患者2969美元）方面无显著差异。在研究年度，干预组患者的急诊就诊次数降至平均每位患者1.7次，对照组为2.4次；住院次数干预组降至平均每位患者0.2次，对照组为0.5次。干预组哮喘医疗保健平均费用每名儿童每年减少721美元，对照组每名患者每年减少178美元。
针对医疗补助保险覆盖的哮喘儿童的综合性哮喘干预项目可显著改善健康结果，同时降低医疗保健成本。哮喘教育、医疗保健结果、医疗补助、哮喘外展、医疗服务利用
