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Related Experiment Videos

Asthma home teaching: two evaluation approaches.

Janet M Catov1, Gary M Marsh, Ada O Youk

  • 1Health and Member Services, Gateway Health Plan, Pittsburgh, Pennsylvania 15219, USA. jcatov@gatewayhealthplan.com

Disease Management : DM
|June 22, 2005
PubMed
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Home-based teaching for asthma patients significantly reduced hospital admissions and emergency department visits in a pre-post study. However, a more rigorous design with a control group found no significant impact, highlighting the importance of study design in evaluating disease management programs.

Area of Science:

  • Public Health
  • Health Services Research
  • Asthma Management

Background:

  • Asthma is a significant public health concern, particularly among Medicaid-managed care populations.
  • Effective disease management programs are crucial for reducing healthcare utilization and improving patient outcomes.
  • Home-based interventions show promise but require rigorous evaluation to determine true impact.

Purpose of the Study:

  • To evaluate the effectiveness of a home-based teaching program in reducing asthma-related hospital admissions and emergency department (ED) visits.
  • To compare the impact of two quasi-experimental designs in assessing program effectiveness.
  • To identify potential disparities in program impact among different demographic subgroups.

Main Methods:

  • Historical-prospective study using health plan administrative data for 381 high-risk asthma patients.

Related Experiment Videos

  • Employed two quasi-experimental designs: a one-group pre/post-test and an untreated control group design with pre/post test.
  • Utilized Poisson regression models to analyze asthma-related event rates based on program enrollment and demographic factors.

    • Main Results:

    • The one-group pre/post-test design showed statistically significant reductions in admissions and ED visits (p < 0.001).
    • The untreated control group design found no significant association between program enrollment and utilization (p = 0.510).
    • Marginally significant impact observed for White patients, but not for Black patients; subgroup analyses revealed program improvement opportunities.

    Conclusions:

    • The choice of study design significantly influences the perceived impact of disease management programs.
    • An external control group design provides a more accurate assessment of true program effectiveness.
    • Subgroup analyses are essential for tailoring interventions and optimizing program outcomes for diverse populations.