[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.
Leiter des Instituts für Verhaltensmedizin bei Neurodermitis und Asthma, CJD Asthmazentrum Berchtesgaden (Dr. med. Josef Lecheler), Berchtesgaden. Gerd.Schauerte@cjd.de
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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