A Matched-Cohort Evaluation of a Bedside Asthma Intervention for Patients Hospitalized at a Large Urban Children’s Hospital

Abstract

Emergency care and hospitalizations account for 36% of asthma-related medical expenses for children. National asthma guidelines emphasize the need for asthma self-management education at multiple points of care, including the hospital, to help prevent acute exacerbations. The integration of a bedside asthma education program into discharge planning at a busy urban children's hospital aimed to reduce repeat emergency department (ED) visits and hospitalizations by educating the community's highest-risk children and their families about asthma. A trained respiratory professional provided 45 minutes of individualized bedside education to families at the hospital and one follow-up support phone call within 3 weeks after discharge. Children receiving the intervention were matched to a control group of children not receiving the intervention by age and 2 markers of past utilization using data obtained from hospital records. Repeat ED utilization was analyzed using a Cox proportional hazards model controlling for sex, residence, race or ethnicity, and year. Compared to 698 matched controls, no significant improvement was observed in the 698 intervention participants or any subgroups followed for 12 months after the intervention.

Caregiver Asthma Knowledge, Aptitude, and Practice in High Healthcare Utilizing Children: Effect of an Educational Intervention

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How can we support children, adolescents and young adults in managing chronic health challenges? A scoping review on the effects of patient education interventions

“…Of the studies dealing with patient education interventions, 14/17 studies resulted in beneficial effects as measured by one or several health economic outcomes . Three studies found no health economic impact or effects of the interventions . Use of urgent health care or the frequency of emergency visits, visits to the local doctor and hospitalization, and missed schooldays were frequently investigated in these studies.…”

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Pediatric hospital discharge interventions to reduce subsequent utilization: A systematic review

“…Studies varied regarding the timing and nature of the intervention components. Eight discharge interventions included a major inpatient component, in addition to outpatient support or follow‐up . Two studies included an inpatient education component only .…”