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Reducing hospitalizations of children with asthma
Insights
A behavioral intervention reduced hospital stays for children with asthma. This "time-out" from positive reinforcement decreased hospitalization duration and frequency, improving outcomes.
Area of Science:
- Pediatric Medicine
- Behavioral Psychology
- Health Services Research
Background:
- Asthma is a common childhood illness requiring hospitalization.
- Some children with asthma utilize hospital services excessively, disproportionate to their condition's severity.
- Behavioral interventions can modify patient behaviors and resource utilization.
Purpose of the Study:
- To evaluate the effectiveness of a behavioral intervention in reducing in-hospital time for pediatric asthma patients.
- To assess the impact of a
- time-out
- from positive reinforcement strategy on hospitalization metrics.
- To determine if this intervention impacts the time to reverse airflow obstruction.
Main Methods:
- A cohort of seven pediatric asthma patients with high hospital utilization was selected.
- A behavioral intervention,
- time-out
- from positive reinforcement, was implemented.
- Patients were monitored for at least one year pre- and post-intervention, measuring hospitalization duration, frequency, and peak expiratory flow rates.
Main Results:
- The intervention significantly reduced the duration of hospitalizations.
- A decrease in the frequency of hospital admissions was observed.
- The time required to reverse airflow obstruction after admission showed improvement.
Conclusions:
- Behavioral interventions, specifically
- time-out
- from positive reinforcement, can effectively reduce hospital resource utilization in select pediatric asthma patients.
- This approach offers a potential strategy for managing excessive healthcare use in chronic pediatric conditions.
- Further research is warranted to explore the long-term effects and broader applicability of this intervention.
Abstract:
This study sought to determine if the amount of in-hospital time could be reduced for a selected population of asthmatic children by using a behavioral intervention ("time-out" from positive reinforcement) in a general pediatric hospital. The measurements of hospital use selected were duration and frequency of hospitalization, and the time needed after admission to reverse airflow obstruction, as reflected by peak expiratory flow rates. Seven patients were selected because their use of the hospital appeared to be appreciably in excess of the severity of their asthma. All seven had been followed for at least one year prior to intervention, and were then followed for at least one year after the initial intervention. Intervention was a time-out procedure consisting of a program that removed many of the social rewards for being hospitalized. The results indicated that each of the measures of hospital use tested was reduced during and following the intervention.