Evaluation of a statewide medical home program on children and young adults with asthma

Area of Science:

• Pediatric Healthcare
• Chronic Disease Management
• Healthcare Coordination

Background:

• Asthma is the most common chronic condition in children, leading to high healthcare use and reduced quality of life.
• Medical home care coordination is standard but lacks rigorous evaluation.
• This study addresses the need to evaluate care coordination's impact on pediatric asthma.

Purpose of the Study:

• To evaluate the impact of care coordination within a medical home model on healthcare utilization and quality of life for children and young adults with asthma.
• To test the hypothesis that formal medical home programs improve asthma management outcomes.
• To assess feasibility and potential benefits of care coordination for pediatric asthma.

Main Methods:

• Pilot study involving 967 children/young adults (birth to 24 years) with asthma.
• Participants received care from 20 pediatric practices within the Pennsylvania Medical Home Initiative.
• Data collected on care coordination encounters, healthcare utilization, and quality of life measures.

Main Results:

• Over 100 days, 9240 care coordination encounters occurred, averaging 20.7 minutes.
• Referral management was the most common activity (21%); coordinators frequently contacted families and specialists (75%).
• Increased time in the medical home program correlated with significant decreases in school absences, emergency department visits, and acute care visits (p < 0.05).

Conclusions:

• Care coordination for pediatric asthma within a medical home model is feasible.
• This approach shows potential for improving healthcare utilization, reducing expenditures, and enhancing quality of life.
• Larger-scale implementation of medical home models with care coordination is recommended for pediatric asthma and other conditions.