Inpatient Electronic-Consults for Asthma Hospitalization Improve Outpatient Outcomes

Area of Science:

• Allergy and Immunology
• Pulmonology
• Healthcare Quality Improvement

Background:

• Asthma exacerbations commonly result in systemic corticosteroid use, emergency department visits, and hospitalizations.
• A gap often exists in outpatient follow-up care after inpatient asthma treatment.
• Specialist care is crucial for improving asthma outcomes.

Purpose of the Study:

• To evaluate the clinical impact of an allergy/immunology (A/I) electronic consult (e-consult) for patients hospitalized with asthma exacerbation.
• To assess the effectiveness of inpatient A/I e-consults in improving asthma management and reducing healthcare utilization.

Main Methods:

• A quality improvement project involving inpatient A/I e-consults for all asthma admissions.
• Tracking clinical outcomes for one year post-consultation.
• Utilizing descriptive statistics and paired T-tests for data analysis.

Main Results:

• 133 patients were enrolled; 57% female, 48% Black, 27% Hispanic.
• Following the e-consult, hospitalization decreased from 1.38 to 0.42 (p<.0001).
• Emergency department/urgent care visits decreased from 1.35 to 0.70 (p=.0025), and systemic corticosteroid courses decreased from 2.74 to 1.43 (p<.0001).

Conclusions:

• Inpatient A/I e-consults for asthma exacerbations effectively reduced systemic corticosteroid use.
• This intervention significantly decreased healthcare utilization, including hospitalizations and ED/UC visits.
• The positive impact was observed in both pediatric and adult patients, irrespective of their follow-up adherence.