A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma

Maureen R. George, Liza C. O'Dowd, Iris Martin, Kathleen O. Lindell, Fay Whitney, Martha Jones, Tracey Ramondo, Lynne Walsh, Jacqueline Grissinger, John Hansen-Flaschen, Reynold A. Panettieri

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: Despite improved understanding of the pathophysiology of asthma, morbidity and mortality continue to rise, with disproportionate increases occurring among urban, indigent minorities. New approaches in the management of asthma are therefore necessary to reverse these dramatic and costly trends. Objective: To determine if patients who are admitted to the hospital with acute asthma and receive inpatient education will have improved outpatient follow-up and clinical outcome measures compared with those receiving conventional care. Methods: Patients enrolled in the study had a primary admission diagnosis of asthma and were between ages 18 and 45 years. Exclusion criteria included comorbid disease, inability to speak English, absence of a telephone in the primary residence, or pregnancy. Seventy-seven patients admitted from the emergency department with asthma were randomized to either the inpatient educational program (IEP) or routine care (control group). Patients in the IEP received asthma education, bedside spirometry, a telephone call 24 hours after discharge, and scheduled follow-up in an outpatient asthma program within 1 week of discharge. Those individuals randomized to the routine management group received conventional inpatient asthma care and routine follow-up. Results: The patients enrolled in the IEP had a markedly higher follow-up rate compared with outpatient appointments (60% vs 27%; P = .01) and significantly fewer emergency department visits (P = .04) and hospitalizations (P = .04) for asthma in the 6 months following IEP intervention, as compared with control patients. This represented a substantial cost savings to the managed care organization. Conclusion: Our study suggests that an IEP in the treatment of indigent, inner-city patients hospitalized with asthma reduces the need for subsequent emergent care and improves outpatient follow-up in a cost-effective manner.

Original languageEnglish (US)
Pages (from-to)1710-1716
Number of pages7
JournalArchives of Internal Medicine
Volume159
Issue number15
DOIs
StatePublished - Aug 9 1999

Fingerprint

Asthma
Outcome Assessment (Health Care)
Inpatients
Outpatients
Poverty
Telephone
Hospital Emergency Service
Education
Aftercare
Cost Savings
Spirometry
Managed Care Programs
Ambulatory Care
Appointments and Schedules
Hospitalization
Organizations
Morbidity
Costs and Cost Analysis
Pregnancy
Control Groups

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

George, Maureen R. ; O'Dowd, Liza C. ; Martin, Iris ; Lindell, Kathleen O. ; Whitney, Fay ; Jones, Martha ; Ramondo, Tracey ; Walsh, Lynne ; Grissinger, Jacqueline ; Hansen-Flaschen, John ; Panettieri, Reynold A. / A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma. In: Archives of Internal Medicine. 1999 ; Vol. 159, No. 15. pp. 1710-1716.
@article{e541339a50704e108644e7f439465bc7,
title = "A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma",
abstract = "Background: Despite improved understanding of the pathophysiology of asthma, morbidity and mortality continue to rise, with disproportionate increases occurring among urban, indigent minorities. New approaches in the management of asthma are therefore necessary to reverse these dramatic and costly trends. Objective: To determine if patients who are admitted to the hospital with acute asthma and receive inpatient education will have improved outpatient follow-up and clinical outcome measures compared with those receiving conventional care. Methods: Patients enrolled in the study had a primary admission diagnosis of asthma and were between ages 18 and 45 years. Exclusion criteria included comorbid disease, inability to speak English, absence of a telephone in the primary residence, or pregnancy. Seventy-seven patients admitted from the emergency department with asthma were randomized to either the inpatient educational program (IEP) or routine care (control group). Patients in the IEP received asthma education, bedside spirometry, a telephone call 24 hours after discharge, and scheduled follow-up in an outpatient asthma program within 1 week of discharge. Those individuals randomized to the routine management group received conventional inpatient asthma care and routine follow-up. Results: The patients enrolled in the IEP had a markedly higher follow-up rate compared with outpatient appointments (60{\%} vs 27{\%}; P = .01) and significantly fewer emergency department visits (P = .04) and hospitalizations (P = .04) for asthma in the 6 months following IEP intervention, as compared with control patients. This represented a substantial cost savings to the managed care organization. Conclusion: Our study suggests that an IEP in the treatment of indigent, inner-city patients hospitalized with asthma reduces the need for subsequent emergent care and improves outpatient follow-up in a cost-effective manner.",
author = "George, {Maureen R.} and O'Dowd, {Liza C.} and Iris Martin and Lindell, {Kathleen O.} and Fay Whitney and Martha Jones and Tracey Ramondo and Lynne Walsh and Jacqueline Grissinger and John Hansen-Flaschen and Panettieri, {Reynold A.}",
year = "1999",
month = "8",
day = "9",
doi = "10.1001/archinte.159.15.1710",
language = "English (US)",
volume = "159",
pages = "1710--1716",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "15",

}

George, MR, O'Dowd, LC, Martin, I, Lindell, KO, Whitney, F, Jones, M, Ramondo, T, Walsh, L, Grissinger, J, Hansen-Flaschen, J & Panettieri, RA 1999, 'A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma', Archives of Internal Medicine, vol. 159, no. 15, pp. 1710-1716. https://doi.org/10.1001/archinte.159.15.1710

A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma. / George, Maureen R.; O'Dowd, Liza C.; Martin, Iris; Lindell, Kathleen O.; Whitney, Fay; Jones, Martha; Ramondo, Tracey; Walsh, Lynne; Grissinger, Jacqueline; Hansen-Flaschen, John; Panettieri, Reynold A.

In: Archives of Internal Medicine, Vol. 159, No. 15, 09.08.1999, p. 1710-1716.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma

AU - George, Maureen R.

AU - O'Dowd, Liza C.

AU - Martin, Iris

AU - Lindell, Kathleen O.

AU - Whitney, Fay

AU - Jones, Martha

AU - Ramondo, Tracey

AU - Walsh, Lynne

AU - Grissinger, Jacqueline

AU - Hansen-Flaschen, John

AU - Panettieri, Reynold A.

PY - 1999/8/9

Y1 - 1999/8/9

N2 - Background: Despite improved understanding of the pathophysiology of asthma, morbidity and mortality continue to rise, with disproportionate increases occurring among urban, indigent minorities. New approaches in the management of asthma are therefore necessary to reverse these dramatic and costly trends. Objective: To determine if patients who are admitted to the hospital with acute asthma and receive inpatient education will have improved outpatient follow-up and clinical outcome measures compared with those receiving conventional care. Methods: Patients enrolled in the study had a primary admission diagnosis of asthma and were between ages 18 and 45 years. Exclusion criteria included comorbid disease, inability to speak English, absence of a telephone in the primary residence, or pregnancy. Seventy-seven patients admitted from the emergency department with asthma were randomized to either the inpatient educational program (IEP) or routine care (control group). Patients in the IEP received asthma education, bedside spirometry, a telephone call 24 hours after discharge, and scheduled follow-up in an outpatient asthma program within 1 week of discharge. Those individuals randomized to the routine management group received conventional inpatient asthma care and routine follow-up. Results: The patients enrolled in the IEP had a markedly higher follow-up rate compared with outpatient appointments (60% vs 27%; P = .01) and significantly fewer emergency department visits (P = .04) and hospitalizations (P = .04) for asthma in the 6 months following IEP intervention, as compared with control patients. This represented a substantial cost savings to the managed care organization. Conclusion: Our study suggests that an IEP in the treatment of indigent, inner-city patients hospitalized with asthma reduces the need for subsequent emergent care and improves outpatient follow-up in a cost-effective manner.

AB - Background: Despite improved understanding of the pathophysiology of asthma, morbidity and mortality continue to rise, with disproportionate increases occurring among urban, indigent minorities. New approaches in the management of asthma are therefore necessary to reverse these dramatic and costly trends. Objective: To determine if patients who are admitted to the hospital with acute asthma and receive inpatient education will have improved outpatient follow-up and clinical outcome measures compared with those receiving conventional care. Methods: Patients enrolled in the study had a primary admission diagnosis of asthma and were between ages 18 and 45 years. Exclusion criteria included comorbid disease, inability to speak English, absence of a telephone in the primary residence, or pregnancy. Seventy-seven patients admitted from the emergency department with asthma were randomized to either the inpatient educational program (IEP) or routine care (control group). Patients in the IEP received asthma education, bedside spirometry, a telephone call 24 hours after discharge, and scheduled follow-up in an outpatient asthma program within 1 week of discharge. Those individuals randomized to the routine management group received conventional inpatient asthma care and routine follow-up. Results: The patients enrolled in the IEP had a markedly higher follow-up rate compared with outpatient appointments (60% vs 27%; P = .01) and significantly fewer emergency department visits (P = .04) and hospitalizations (P = .04) for asthma in the 6 months following IEP intervention, as compared with control patients. This represented a substantial cost savings to the managed care organization. Conclusion: Our study suggests that an IEP in the treatment of indigent, inner-city patients hospitalized with asthma reduces the need for subsequent emergent care and improves outpatient follow-up in a cost-effective manner.

UR - http://www.scopus.com/inward/record.url?scp=0033598097&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033598097&partnerID=8YFLogxK

U2 - 10.1001/archinte.159.15.1710

DO - 10.1001/archinte.159.15.1710

M3 - Article

C2 - 10448773

AN - SCOPUS:0033598097

VL - 159

SP - 1710

EP - 1716

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 15

ER -