Translation of a pediatric asthma-management program into a community in Connecticut.
OBJECTIVE
We assessed whether a successful asthma-management program could be translated into pediatrician's offices, improve care, and reduce medical services use.


METHODS
Pediatrician's offices from 6 communities in Connecticut were trained, and all children aged 6 months or older were eligible for enrollment. Quality measures included enrollment numbers, appropriate use of anti-inflammatory therapy, and distribution of a written treatment plan. Medical services utilization data for Medicaid-insured children were expressed as relative rates (RRs) (95% confidence intervals [CIs]) before and after enrollment, and we used historical and contemporaneous comparisons and generalized estimating equations.


RESULTS
A total of 51 practices and 297 clinicians enrolled 32 680 children from 2002 to 2007; 10 467 had asthma, of whom 4354 were insured with Medicaid. Children with persistent asthma experienced decreases in the number of hospitalizations (RR: 0.51 [95% CI: 0.39-0.65]) and emergency-department visits (RR: 0.70 [95% CI: 0.68-0.84]), and there was no change in number of outpatient visits (RR: 0.99 [95% CI: 0.9-1.10]). Inhaled corticosteroid use doubled, appropriate use of anti-inflammatory therapy increased to 96%, and 94% of the children were given a written treatment plan.


CONCLUSIONS
General pediatricians can successfully implement an asthma-management program that is effective in improving care for large numbers of children.
Asthma Center, Connecticut Children's Medical Center, 282 Washington St, Hartford, CT 06106, USA. mclouti@ccmckids.org
Michelle M
MM
Cloutier
Dorothy B
DB
Wakefield
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D003237:Connecticut; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D012041:Regional Medical Programs