[COPD home visit with children. Comparison of the quality of various models]

This article reports on the quality and efficiency of asthma home visits paid by nurses. These home visits were part of a research project on out-of-hospital asthma care for children in the province of Noord-Holland (the Netherlands). In this project we compared three different models of out-of-hospital nursing care for asthmatic children: a. care delivered by local generalist community nurses; b. care delivered by local community nurses who are partly specialized in asthma care; c. care delivered by specialist hospital-based asthma nurses. A total of 120 children with asthmatic complaints were randomly assigned to one of those models. Based on literature study and interviews with experts in the field, criteria were developed for quality and efficiency of asthma home care for children. Interviews with the parents of the children involved in the project provided information on the content and the duration of the home visits as well as on their evaluation on the care received. One of the (unexpected) findings was that in all three models of care very little attention was given to important aspects such as prescribed medication and the use of inhalers and psychosocial factors that made be related to the complaints. Previous experience of the nurses in asthma home visits proved to be an important aspect of the quality of care.