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Asthma Care from Home: Study protocol for an effectiveness-implementation evaluation of a virtually enabled asthma
Ryan Mackle1,2, Carmen Crespo Gonzalez1, Mei Chan1
1Discipline of Paediatrics and Child Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
Insights
This study introduces a virtual asthma care model for Australian children to reduce hospitalizations and improve care access, especially in rural areas. The project evaluates its impact, implementation, and cost-effectiveness for sustainable, scalable solutions.
Area of Science:
- Pediatric Respiratory Medicine
- Health Services Research
- Digital Health Innovations
Background:
- Asthma is a primary cause of unscheduled hospitalizations in Australian children, highlighting significant healthcare burdens and access disparities.
- Inequitable access to comprehensive, ongoing pediatric asthma care is a critical issue in Australia.
Purpose of the Study:
- To evaluate a comprehensive, virtually enabled asthma care model designed to reduce hospitalizations and improve care access for children.
- To assess the model's impact on healthcare utilization, asthma control, and patient/provider satisfaction.
- To understand the implementation process and economic viability for scalability and sustainability.
Main Methods:
- A quasi-experimental pre/post impact evaluation of the Asthma Care from Home Project.
- Mixed-methods implementation evaluation to analyze intervention effectiveness and system changes.
- Economic evaluation from family and health service perspectives to determine cost-effectiveness.
Main Results:
- The study will assess the model's impact on healthcare utilization and asthma control measures.
- Implementation evaluation will identify factors contributing to or hindering the intervention's success.
- Economic evaluation will determine the cost-effectiveness of providing asthma care from home.
Conclusions:
- The Asthma Care from Home Project aims to enhance asthma care accessibility for children, particularly in rural and remote regions.
- Implementation and economic evaluations are crucial for understanding the model's long-term sustainability and scalability.
Background:
Asthma is the leading source of unscheduled hospitalisation in Australian children, with a high burden placed upon children, their parents/families, and the healthcare system. In Australia, there are widening disparities in paediatric asthma care including inequitable access to comprehensive ongoing and planned asthma care for children.
Methods:
The Asthma Care from Home Project is a comprehensive virtually enabled asthma model of care that aims to a. supports families, communities and healthcare providers, b. flexible and locally acceptable, and c. allow for adoption of innovations such as digital technologies so that asthma care can be provided "from home", reduce potentially preventable asthma hospitalisation, and ensure satisfaction at a patient, family, and healthcare provider level. The model of care includes standardisation of discharge care through provision of an asthma discharge resource pack containing individual asthma action plan, follow-up letters for the child's general practitioner (GP) and school/child care, and access to online asthma educational sessions and resource; post-discharge care coordination through text message reminders for families for regular GP review, email correspondence with their child's GP and school/childcare; and virtual home visits to discuss home environmental triggers, provide personalised asthma education and respond to parental concerns relating to their child's asthma. This study is comprised of three components: 1) a quasi-experimental pre/post impact evaluation assessing the impact of the model on healthcare utilisation and asthma control measures; 2) a mixed-methods implementation evaluation to understand how and why our intervention was effective or ineffective in producing systems change; 3) an economic evaluation to assess the cost-effectiveness of the proposed model of care from a family and health services perspective.
Discussion:
This study aims to improve access to asthma care for children in rural and remote areas. Implementation evaluation and economic evaluation will provide insights into the sustainability and scalability of the asthma model of care.
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