Improvements in Cystic Fibrosis Quarterly Visits, Lung Function Tests, and Respiratory Cultures

Abstract

The Cystic Fibrosis (CF) Foundation recommends patients attend clinic $4 times per year with 4 respiratory cultures and 2 pulmonary function tests (PFTs). However, nationally only 57.4% of patients met these guidelines in 2012. We used a quality improvement program with a goal of 75% of our patients meeting this care guideline by 2012.

The utility of including pathology reports in improving the computational identification of patients

“…[23] As with many chronic diseases, quality improvement approaches can be applied to populations of patients with CD to standardize care and track outcomes. [456] Effectively identifying and tracking outcomes of these cohorts of patients requires the development of an accurate CD patient registry.…”

Health insurance and use of recommended routine care in adults with cystic fibrosis

“…All remaining years with data on health insurance coverage and routine care use were selected for analysis. The primary outcome was receiving recommended care in a given year, defined as ≥4 clinic visits, ≥4 respiratory cultures and ≥2 PFTs . Sensitivity analyses used an alternative definition of ≥4 clinic visits, ≥1 respiratory culture and ≥2 PFTs per year.…”

“…The primary outcome was receiving recommended care in a given year, defined as 4 clinic visits, 4 respiratory cultures and 2 PFTs. 14,15 Sensitivity analyses used an alternative definition of 4 clinic visits, 1 respiratory culture and 2 PFTs per year. For patients with FEV1 <70% predicted in a given year, a secondary outcome of adherence to recommended medications was defined as use of dornase alfa and, if respiratory cultures were positive for P. aeruginosa, use of tobramycin or aztreonam in that year.…”

The effect of the affordable care act dependent coverage provision on patients with cystic fibrosis

“…Using a difference‐in‐difference approach, we investigated whether the ACA dependent coverage provision increased access to private insurance (relative to using public insurance or having no insurance coverage) among young adults with CF. Our secondary aim was to determine whether this policy increased use of routine CF care (≥4 clinic visits, ≥4 respiratory cultures, and ≥2 pulmonary function tests) in a given year …”

“…Our secondary aim was to determine whether this policy increased use of routine CF care (!4 clinic visits, !4 respiratory cultures, and !2 pulmonary function tests) in a given year. 17…”