Robert Hamburger1,2, Zekarias Berhane2, Molly Gatto3, Suzanne Yunghans4, Renee K Davis5, Renee M Turchi5,6,7. 1. a Nova Southeastern University College of Osteopathic Medicine , Fort Lauderdale , FL , USA . 2. b Department of Epidemiology and Biostatistics , School of Public Health, Drexel University , Philadelphia , PA , USA . 3. c Make-A-Wish Foundation of Philadelphia and Susquehanna Valley , Blue Bell , PA , USA . 4. d Pennsylvania Chapter, American Academy of Pediatrics , Media , PA , USA . 5. e Department of Community Health and Prevention , Maternal and Child Health Working Group, School of Public Health, Drexel University , Philadelphia , PA , USA . 6. f Department of Pediatrics , St. Christopher's Hospital for Children , Philadelphia , PA , USA , and. 7. g Department of Community Health and Prevention , School of Public Health, Drexel University , Philadelphia , PA , USA.
Abstract
OBJECTIVE: Asthma, the most common chronic condition among children, accounts for significant healthcare utilization and impact on quality of life. Care coordination in a medical home is considered standard practice, but has not been rigorously evaluated. METHODS: We initiated this pilot study of children/young adults with asthma (n = 967), ages: birth to 24 years, receiving care from a subset of pediatric practices (n = 20) participating in the Pennsylvania Medical Home Initiative, Educating Practices in Community-Integrated Care (92 practices statewide). We hypothesized children and youth with asthma receiving care coordination in the context of a formal medical home program would experience favorable associations with healthcare utilization and quality of life measures. RESULTS: A total of 9240 care coordination encounters for this cohort of children/youth occurred over 100 days. The average length of care coordination encounter was 20.7 minutes. The most common care coordination activity was referral management (21%) and the care coordinator in the practice most often contacted parent/family and specialists (75%). Children with more severe asthma had more hospitalizations and emergency department (ED) visits than children with less severe asthma. There was a significant decrease in school absences, ED visits and acute care visits for children/youth with asthma with increasing length of time in a medical home program (p < 0.05). CONCLUSION: Care coordination for children/youth with asthma is feasible and may yield improvements in healthcare utilization, expenditures and quality of life. Larger-scale implementation of care coordination and medical home models for children/youth with asthma and other diagnoses are warranted.
OBJECTIVE:Asthma, the most common chronic condition among children, accounts for significant healthcare utilization and impact on quality of life. Care coordination in a medical home is considered standard practice, but has not been rigorously evaluated. METHODS: We initiated this pilot study of children/young adults with asthma (n = 967), ages: birth to 24 years, receiving care from a subset of pediatric practices (n = 20) participating in the Pennsylvania Medical Home Initiative, Educating Practices in Community-Integrated Care (92 practices statewide). We hypothesized children and youth with asthma receiving care coordination in the context of a formal medical home program would experience favorable associations with healthcare utilization and quality of life measures. RESULTS: A total of 9240 care coordination encounters for this cohort of children/youth occurred over 100 days. The average length of care coordination encounter was 20.7 minutes. The most common care coordination activity was referral management (21%) and the care coordinator in the practice most often contacted parent/family and specialists (75%). Children with more severe asthma had more hospitalizations and emergency department (ED) visits than children with less severe asthma. There was a significant decrease in school absences, ED visits and acute care visits for children/youth with asthma with increasing length of time in a medical home program (p < 0.05). CONCLUSION: Care coordination for children/youth with asthma is feasible and may yield improvements in healthcare utilization, expenditures and quality of life. Larger-scale implementation of care coordination and medical home models for children/youth with asthma and other diagnoses are warranted.
Entities:
Keywords:
Asthma; care coordination; children and youth with special healthcare needs; healthcare utilization; medical home; young adults
Authors: David J Kolko; Elizabeth A McGuier; Renee Turchi; Eileen Thompson; Satish Iyengar; Shawna N Smith; Kimberly Hoagwood; Celeste Liebrecht; Ian M Bennett; Byron J Powell; Kelly Kelleher; Maria Silva; Amy M Kilbourne Journal: Implement Sci Date: 2022-02-22 Impact factor: 7.960
Authors: Nusrat Homaira; Emma Dickins; Stephanie Hodgson; Mei Chan; Sandra Wales; Melinda Gray; Sarah Donnelly; Christine Burns; Louisa Owens; Michael Plaister; Anthony Flynn; Jennifer Andresen; Kimberley Keane; Karen Wheeler; Bronwyn Gould; Nadine Shaw; Adam Jaffe; Christie Breen; Lisa Altman; Susan Woolfenden Journal: Front Pediatr Date: 2022-09-23 Impact factor: 3.569