Reducing Quality of Care Disparities in Childhood Asthma
Combining two evidence-based interventions yielded a reduction in asthma symptoms and health care utilization.
Puerto Rican children have the highest asthma prevalence of all U.S. children. These researchers combined two previously tested asthma interventions into one to implement among children with moderate to severe asthma living in two low-income housing projects in Puerto Rico. The new intervention they called La Red Intervention.
From “Yes We Can” they retained a structural component of an interactive multidisciplinary team—physician-asthma champion, community nurse/coordinator, and community health worker to work with families during clinic visits.
From the “Inner-City Asthma Study” they adapted the remediation of allergens in the home—dust mite impermeable bed covers, vacuuming, and removal of cockroaches—delivered by a community health worker.
Researchers recruited children living with asthma in the housing projects. The most common allergies were to dust mites and cockroaches. The children received nine intervention encounters (three for clinic visits) over 12 months.
Asthma-related hospitalizations were reduced 60 percent; emergency department visits 50 percent. Preventive medication use doubled and rescue medication use decreased 75 percent. The average reduction in simulated total health care expenditures was $5,913, a 45 percent reduction.
At the end of the intervention, half of the caregivers reported having a child asthma action plan, compared to 4 percent at baseline.
Moving the Discourse on Quality in Pediatrics
- 1. Well-Child Care Clinical Practice Redesign for Young Children
- 2. Reducing Quality of Care Disparities in Childhood Asthma
- 3. National Quality Measures for Child Mental Health Care
- 4. Do Parent Perceptions Predict Continuity of Publicly Funded Care for Attention-Deficit/Hyperactivity Disorder?
- 5. Systematic Update of Computerized Physician Order Entry Order Sets to Improve Quality of Care
- 6. Methods of Mortality Risk Adjustment in the NICU
- 7. Accuracy of Hospital Administrative Data in Reporting Central Line-Associated Bloodstream Infections in Newborns
- 8. Variation in Surgical Outcomes for Adolescents and Young Adults with Inflammatory Bowel Disease
- 9. The Factors Associated with High-Quality Communication for Critically Ill Children
- 10. Rapid Adoption of Lactobacillus rhamnosus GG for Acute Gastroenteritis
- 11. Management of Bronchiolitis in the Emergency Department
- 12. Assessing Quality Improvement in Health Care