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Effectiveness of a nurse-led management programme for paediatric asthma in Taiwan
Hui-Ching Weng1, Ben-Chih Yuan, Yu-Tsun Su
1I-Shou University, Ping Tung, Taiwan.
Insights
A government-funded paediatric asthma management program significantly reduced healthcare utilization, including fewer emergency visits and hospitalizations. The program also improved patient self-care skills and knowledge.
Area of Science:
- Public Health
- Healthcare Management
- Pediatrics
Background:
- Paediatric asthma poses a significant public health challenge, necessitating effective disease management strategies.
- Government-sponsored programs aim to improve health outcomes and reduce healthcare costs associated with chronic childhood conditions.
- Assessing the economic impact and patient satisfaction of such programs is crucial for optimizing healthcare delivery.
Purpose of the Study:
- To conduct a preliminary analysis of a government-sponsored disease management program for paediatric asthma.
- To evaluate the program's impact on economic outcomes, specifically healthcare resource utilization.
- To assess patient satisfaction and self-care improvements among participants.
Main Methods:
- A retrospective matched cohort study design compared intervention and control groups.
- Patients were classified as 'already diagnosed' or 'newly diagnosed' based on medical encounters (ICD-9 code 493).
- Healthcare resource utilization (emergency visits, inpatient stays) was compared pre/post intervention and against a control group.
Main Results:
- The intervention group of 'already diagnosed' cases showed substantial reductions in emergency department visits (77.97%), inpatient visits (80.77%), and prolonged hospital stays (75.65%).
- The 'newly diagnosed' intervention group experienced a 35.11% decrease in emergency department visits compared to the control group.
- Patients in the program demonstrated improved adherence to medical advice, enhanced asthma knowledge, and better self-care skills.
Conclusions:
- A nurse-led paediatric asthma management program in Taiwan proved effective in improving health outcomes and reducing healthcare resource utilization.
- The program's success suggests potential for broader implementation and further refinement.
- Recommendations for enhancing the program include simplifying administrative processes and improving information systems.
Aim:
The aim of this study was to carry out a preliminary analysis of the impact of a government-sponsored disease management programme for paediatric asthma on economic outcomes and patient satisfaction.
Methods:
Of the 398 patients who participated in the programme, 249 (62.56%) who had at least two medical care encounters with an ICD-9 code of 493 were classified as 'already diagnosed cases'; and 129 (34.12%) who had a single or no medical care encounter with an ICD-9 code of 493 were classified as 'newly diagnosed cases'. A retrospective 1:4 (intervention vs. control group) matched cohort study design was conducted, with the control group randomly drawn from 236 637 paediatric asthmatics who were not enrolled the programme. Questionnaires were collected from 105 (26.3%) of the patients.
Results:
Comparison results of 1 year pre/post tests of utilisation of health care resources indicated that the intervention group of already diagnosed cases had 77.97% fewer emergency department visits, 80.77% fewer inpatient visits, and 75.65% fewer stays of significant length. For the newly diagnosed group, the intervention group had 35.11% fewer emergency department visits than the control group. The majority of the patients had substantial adherence to physicians' suggestions, more accurate knowledge and better self-care skills concerning asthma.
Conclusion:
A nurse-led management programme has proved useful in managing paediatric asthma in Taiwan. Simplification of paperwork, some reorganisation of the practitioner's daily responsibilities and provision of a fail-safe information system may make the programme even more beneficial.
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