[Children with bronchial asthma: effects of an integrated health-care programme].
BACKGROUND
On 1 (st) June 2005 a contract for an integrated health-care programme (IHP) for infants, children and juveniles with bronchial asthma (2 to 18-year-olds) was concluded. Care providers are specialised paediatricians (PaedNetz Bayern) and two rehabilitation clinics; cost payers are two Bavarian health insurances (DAK, TK).


METHODS
With a questionnaire (Q5) the following 5 items were collected every 12 months: absent days, hospital admissions, days at hospital, emergency visits and use of relievers. To estimate the adherence to the German asthma guidelines, every 6 months the symptoms, therapy and consecutive procedures were recorded.


RESULTS
At the end of 2008, 1280 patients had participated; the follow-up showed a significant reduction of the Q5 items 2 years later. The comparison of patients who had already participated for at least 12 months in the IHP with patients who have just started to participate showed significant reductions (p < 0.05) of all Q5 items between 54 % and 85 %. According to the guidelines - 6 months after starting the IHP - in 25 % a more intense therapy would be helpful. This percentage declines to 17 % at 24 months (p < 0.05).


CONCLUSIONS
Children and juveniles with bronchial asthma who are treated by specialised paediatricians and rehabilitation clinics by means of an integrated health-care program show a significant reduction of absent days, emergency visits, hospitalisations, days in hospital and use of relievers.
Schauerte
G
G
Leiter des Instituts für Verhaltensmedizin bei Neurodermitis und Asthma, CJD Asthmazentrum Berchtesgaden (Dr. med. Josef Lecheler), Berchtesgaden. Gerd.Schauerte@cjd.de
Fendel
T
T
Schwab
S
S
Bredl
C
C
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003284:Contract Services; D019033:Delivery of Health Care, Integrated; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team; D010372:Pediatrics; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D012047:Rehabilitation Centers; D014600:Utilization Review / Q000706:statistics & numerical data