A randomized controlled trial of a pediatric asthma outreach program

Area of Science:

• Pediatric Pulmonology
• Healthcare Management
• Public Health Interventions

Background:

• Asthma education and case management interventions have shown potential in reducing asthma-related emergency care, hospitalizations, and healthcare expenditures.
• Previous research suggests that comprehensive asthma management strategies can positively impact patient outcomes and resource utilization.

Purpose of the Study:

• To evaluate the impact of an asthma outreach program (AOP), a team-based case management approach, on emergency ward (EW) visits and overall hospital utilization in pediatric asthma patients.
• To assess the cost-effectiveness of the AOP intervention compared to standard educational interventions.

Main Methods:

• A randomized controlled trial involving 57 pediatric asthma patients (aged 1-15 years) enrolled in a health maintenance organization.
• Patients were randomized into two groups: a control group receiving intensive asthma education and an AOP group receiving initial education followed by ongoing case management by a nurse.

Main Results:

• The AOP group experienced significant reductions in EW visits (73%), hospitalizations (84%), and outside-of-health-plan costs (82%) compared to baseline.
• When compared to the control group, the AOP group showed additional significant reductions in EW visits (57%), hospitalizations (75%), and outside-of-health-plan use (71%).
• The AOP intervention yielded direct savings to the health plan ranging from $7.69 to $11.67 for every dollar spent on the case management nurse.

Conclusions:

• The asthma outreach program (AOP) significantly decreased resource utilization in pediatric asthma patients by 57% to 75% compared to a control group receiving only educational intervention.
• The AOP intervention proved to be highly cost-effective, generating substantial savings relative to the program's operational costs.