The Chicago Asthma Surveillance Initiative: a community-based approach to understanding asthma care

Nearly all of the asthma surveillance literature focuses on national-, regional-, or state-based estimates of prevalence, health-care utilization (specifically hospitalizations, emergency department, and ambulatory care visits), and mortality. Although these are important events, they reveal little about asthma's impact at the community level and provide little information that could be used to design specific interventions for improving clinical outcomes. A useful representation of asthma care across a community could guide an effective community response to the burden of asthma. The goal of the Chicago Asthma Surveillance Initiative (CASI) is to develop a community-wide surveillance program that characterizes and monitors asthma care in the Chicago area, beyond existing public health surveillance. To accomplish this, CASI surveyed Chicago-area hospitals, emergency departments, primary care physicians, specialty care physicians, pharmacists, managed care organizations, the general public, and persons or families affected by asthma to learn about asthma care and its outcomes. A variety of techniques (including brochures, slide kits, and the Internet) were used to achieve rapid public dissemination of study findings. The value of this comprehensive community-based data surveillance effort will rest on how the community uses this information to stimulate new efforts to improve asthma care and reduce untoward outcomes.