Holder-Niles Faye, Haynes Linda, D'Couto Helen, Hehn Rebecca S, Graham Dionne A, Wu Ann Chen, Cox Joanne E
1 Boston Children's Hospital, Boston, MA, USA.
2 Harvard Medical School, Boston, MA, USA.
Clin Pediatr (Phila). 2017 Sep;56(10):934-941. doi: 10.1177/0009922817705186. Epub 2017 Apr 24.
Innovative approaches within primary care are needed to reduce fragmented care, increase continuity of care, and improve asthma outcomes in children with asthma. Our objective was to assess the impact of coordinated team-based asthma care on unplanned asthma-related health care utilization. A multidisciplinary asthma team was developed to provide coordinated care to high-risk asthma patients. Patients received an in-depth diagnostic and family needs assessment, asthma education, and coordinated referral to social and community services. Over a 2-year period, 141 patients were followed. At both 1 and 2 years postintervention, there was a significant decrease from preintervention rates in urgent care visits (40%, P = .002; 50%, P < .0001), emergency department visits (63%, P < .0001; 70%, P < .0001), and inpatient hospitalization (69%, P = .002; 54%, P = .04). Our coordinated asthma care program was associated with a reduction in urgent care visits, emergency department visits, and inpatient hospitalizations among high-risk children with asthma.
基层医疗需要创新方法来减少碎片化护理,提高护理的连续性,并改善哮喘儿童的哮喘治疗效果。我们的目标是评估基于团队的协调哮喘护理对与哮喘相关的非计划医疗保健利用的影响。一个多学科哮喘团队被组建起来,为高危哮喘患者提供协调护理。患者接受了深入的诊断和家庭需求评估、哮喘教育以及转介至社会和社区服务的协调安排。在两年的时间里,对141名患者进行了跟踪。在干预后的1年和2年,紧急护理就诊率(分别下降40%,P = .002;50%,P < .0001)、急诊科就诊率(分别下降63%,P < .0001;70%,P < .0001)和住院率(分别下降69%,P = .002;54%,P = .04)均较干预前显著降低。我们的协调哮喘护理项目与高危哮喘儿童的紧急护理就诊、急诊科就诊和住院率的降低有关。