Outcomes Evaluation of a Comprehensive Intervention Program for Asthmatic Children Enrolled in Medicaid

Kelly, Cynthia S.; Morrow, Ardythe L.; Shults, Justine; Nakas, Nermina; Strope, Gerald L.; Adelman, Raymond D.

doi:10.1542/peds.105.5.1029

Cited by 207 publications

(129 citation statements)

References 31 publications

(13 reference statements)

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“…Additional long term studies are needed to confirm the findings of this cost analysis of nurseled outpatient management in patients with more severe asthma. Previous studies have evaluated the effect of educational intervention by asthma nurses on the costs of management of asthma both in children and adults [10,12,[22][23][24][25]. The economical consequences of these interventions were inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…The economical consequences of these interventions were inconclusive. Some of these studies reported a cost reduction [10,12,22,23], whilst others found that extra investments were needed to achieve a reduction in healthcare utilisation of the patients [24,25]. In these studies, however, the asthma nurse intervention was additional to the routine medical care.…”

Section: Discussionmentioning

confidence: 99%

“…Regular follow-up is recommended to ensure correct use of prescribed drugs and to reinforce the patient9s and caregiver9s knowledge of asthma and management of the disease. Various intervention studies have demonstrated that patient education, mainly provided by an asthma nurse, resulted in better control of childhood asthma [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, maintenance treatment with inhaled corticosteroids has been shown to be cost effective [19][20][21]. The consequences of intervention by asthma nurses on healthcare costs are, however, inconclusive [10,12,[22][23][24][25]. This may be due to the fact that until now, care provided by an asthma nurse has always been additional to routine medical care.…”

Section: Introductionmentioning

confidence: 99%

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Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Kamps¹,

Roorda²,

Kimpen³

et al. 2004

Eur Respir J

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The high burden of asthma on healthcare utilisation and costs warrants economic appraisal of management approaches. The authors previously demonstrated that the efficacy of nurse-led outpatient management of childhood asthma was comparable to management by a paediatrician and now report on the healthcare utilisation and costs of both management approaches.A total of 74 newly referred children with asthma were randomly assigned to a 1-yr follow-up by paediatricians or asthma nurse. Healthcare utilisation was recorded and associated costs calculated for both management approaches.There were no significant differences in healthcare utilisation except for the total time spent on patient contact (136(n=14) versus 187(n=41) min, for patients followed-up by paediatrician and an asthma nurse repectively). Costs within the healthcare sector were reduced by 7.2% in favour of nurse-led care. The reduction in costs was solely attributable to a 17.5% reduction in the costs of outpatient visits. Nurse-led care appeared to be cost-saving even if the duration of follow-up visits would be twice that of doctor9s visits. Overall healthcare costs (within and outside the healthcare sector) were 4.1% lower for nurse-led outpatient management compared to traditional medical care.Nurse-led outpatient management of childhood asthma can be provided at a lower cost than medical care by paediatricians.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

Kamps¹,

Roorda²,

Kimpen³

et al. 2004

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Pediatric asthma outreach programs improve health outcomes and decrease costs, 67 as do intensive case management programs for children with diabetes. 68 In children with hypoplastic left heart syndrome, Ghanayem et al 69 reported improved survival between the first 2-staged surgical procedures with the use of an intensive home monitoring program.…”

Section: Comprehensive Heart Failure Programsmentioning

confidence: 99%