Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma

Area of Science:

• Pediatric Asthma Management
• Healthcare Transition Programs
• Public Health Interventions

Background:

• Asthma exacerbations in children lead to significant healthcare utilization.
• Effective transition programs are crucial for managing pediatric asthma post-hospitalization.
• Multicomponent interventions may improve care coordination for vulnerable populations.

Purpose of the Study:

• To evaluate a multi-component hospital-to-home (H2H) transition program for children hospitalized with asthma exacerbations.
• To assess the feasibility and acceptability of the H2H program.
• To explore the impact on healthcare utilization, asthma morbidity, and caregiver quality of life.

Main Methods:

• Pilot prospective randomized clinical trial comparing guideline-based asthma care with and without a patient-centered H2H program.
• H2H program included medication access, school-based therapy, home assessments, provider communication, and patient navigator support.
• Outcomes measured included feasibility, acceptability, healthcare utilization, asthma morbidity, and caregiver quality of life.

Main Results:

• The H2H program demonstrated high feasibility, with 100% initiation of key components like medication availability and school-based asthma therapy.
• Acceptability was high, with 87.5% of families continuing school-based therapy and finding home visit referrals helpful.
• No significant differences in healthcare utilization were observed between groups, adjusting for baseline characteristics.

Conclusions:

• Comprehensive care coordination initiated during inpatient stays is feasible and acceptable for pediatric asthma patients.
• Pilot data support the need for a larger trial to determine the intervention's effectiveness in reducing healthcare utilization.
• The intervention shows promise for urban, minority children with asthma requiring improved post-discharge care.