TY - JOUR
T1 - Reducing potentially preventable health events among patients with asthma through multi-state, multi-center quality improvement program
AU - Rojanasarot, Sirikan
AU - Carlson, Angeline M.
AU - St. Peter, Wendy L.
AU - Karaca-Mandic, Pinar
AU - Wolfson, Julian
AU - Schommer, Jon C.
N1 - Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.
PY - 2021
Y1 - 2021
N2 - Introduction: Enhancing Care for Patients with Asthma is a multi-state, multi-center quality improvement program developed to augment guideline-based practice among health care providers through Plan-Do-Study-Act cycle. This study examined the association between the implementation of the guideline-based quality improvement program and subsequent changes in asthma-related emergency room visits and hospitalizations. Methods: This retrospective, interrupted time-series study used administrative claims data from a private insurer that provided coverage to patients receiving care from participating health centers (15 centers in New Mexico, Oklahoma, Texas, and Illinois). The 12-month implementation period started in January 2013 for centers in Cohort 1 and October 2013 for centers in Cohort 2. The claims of 1,828 patients with asthma from January 2012 to May 2015 were analyzed. The data included 12-month pre-program implementation, 12-month program implementation, and 5-month post-program completion periods. Results: The average number of asthma-related emergency room visits and hospitalizations decreased from 2.22 to 1.38 and 1.97 to 1.04 per 100 patients per month, respectively, in the 12-month pre-implementation period as compared to 12-month implementation period. The results of three-level generalized linear mixed models found that during the 12-month implementation period, patients had 37.7% and 47.1% lower rates of emergency room visits and hospitalizations, respectively, compared to the 12-month pre-implementation period (p < 0.001 in both comparisons). Conclusions: Enhancing Care for Patients with Asthma is an effective quality improvement program that was successfully executed in diverse geographical states and associated with reductions in potentially preventable health events. The findings support the widespread use of the program in other settings.
AB - Introduction: Enhancing Care for Patients with Asthma is a multi-state, multi-center quality improvement program developed to augment guideline-based practice among health care providers through Plan-Do-Study-Act cycle. This study examined the association between the implementation of the guideline-based quality improvement program and subsequent changes in asthma-related emergency room visits and hospitalizations. Methods: This retrospective, interrupted time-series study used administrative claims data from a private insurer that provided coverage to patients receiving care from participating health centers (15 centers in New Mexico, Oklahoma, Texas, and Illinois). The 12-month implementation period started in January 2013 for centers in Cohort 1 and October 2013 for centers in Cohort 2. The claims of 1,828 patients with asthma from January 2012 to May 2015 were analyzed. The data included 12-month pre-program implementation, 12-month program implementation, and 5-month post-program completion periods. Results: The average number of asthma-related emergency room visits and hospitalizations decreased from 2.22 to 1.38 and 1.97 to 1.04 per 100 patients per month, respectively, in the 12-month pre-implementation period as compared to 12-month implementation period. The results of three-level generalized linear mixed models found that during the 12-month implementation period, patients had 37.7% and 47.1% lower rates of emergency room visits and hospitalizations, respectively, compared to the 12-month pre-implementation period (p < 0.001 in both comparisons). Conclusions: Enhancing Care for Patients with Asthma is an effective quality improvement program that was successfully executed in diverse geographical states and associated with reductions in potentially preventable health events. The findings support the widespread use of the program in other settings.
KW - Asthma
KW - disease management
KW - emergency room visits
KW - hospitalizations
KW - pediatrics
KW - preventable health care utilization
KW - quality improvement
UR - http://www.scopus.com/inward/record.url?scp=85082492586&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082492586&partnerID=8YFLogxK
U2 - 10.1080/02770903.2020.1741611
DO - 10.1080/02770903.2020.1741611
M3 - Article
C2 - 32162561
AN - SCOPUS:85082492586
SN - 0277-0903
VL - 58
SP - 874
EP - 882
JO - Journal of Asthma
JF - Journal of Asthma
IS - 7
ER -