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Improved outcomes for hospitalized asthmatic children using a clinical pathway

C S Kelly1, C L Andersen, J P Pestian

  • 1Department of Pediatrics, Eastern Virginia Medical School, Children's Hospital of The King's Daughter, Norfolk 23507, USA.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|June 1, 2000
PubMed

Insights

Implementing an asthma clinical pathway for children significantly reduced hospital stays and costs. It also improved patient education and home care management for asthma patients.

Area of Science:

  • Pediatric Pulmonology
  • Healthcare Management
  • Clinical Effectiveness Research

Background:

  • Asthma clinical pathways are increasingly utilized in healthcare settings.
  • However, there is a limited number of controlled studies assessing their clinical and economic benefits.
  • This study addresses the need for evidence on the effectiveness of asthma clinical pathways.

Purpose of the Study:

  • To determine the impact of an inpatient asthma clinical pathway on the cost and quality of care for pediatric asthma patients.
  • To provide data on the effectiveness of standardized care protocols in managing childhood asthma exacerbations.

Main Methods:

  • A retrospective cohort study compared 34 children treated with an asthma clinical pathway to 34 matched controls.
  • Patients were matched based on age, race, gender, comorbidities, asthma severity, ICU admission, and admission time.
  • Key outcomes included length of stay, total costs, readmission rates, inpatient management, and discharge medications.

Main Results:

  • The clinical pathway group had a significantly shorter length of stay (36 vs. 71 hours, P < .001) and lower total costs ($1685 vs. $2829, P < .001).
  • Pathway patients were more likely to receive asthma education (65% vs. 18%, P < .001), be discharged with controller medications (88% vs. 53%, P < .01), and have home use devices like peak flow meters (57% vs. 23%, P < .05) and spacers (100% vs. 71%, P < .001).

Conclusions:

  • The inpatient asthma clinical pathway effectively reduced length of stay and healthcare costs.
  • The pathway also enhanced the quality of care for hospitalized children with asthma through improved education and discharge planning.
Abstract

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