Reducing potentially preventable health events among patients with asthma through multi-state, multi-center quality improvement program

Sirikan Rojanasarot, Angeline M. Carlson, Wendy L. St. Peter, Pinar Karaca-Mandic, Julian Wolfson, Jon C. Schommer

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

INTRODUCTION: Enhancing Care for Patients with Asthma is a multi-state, multi-center quality improvement program developed to augment guideline-based practice among health care providers through Plan-Do-Study-Act cycle. This study examined the association between the implementation of the guideline-based quality improvement program and subsequent changes in asthma-related emergency room visits and hospitalizations.

METHODS: This retrospective, interrupted time-series study used administrative claims data from a private insurer that provided coverage to patients receiving care from participating health centers (15 centers in New Mexico, Oklahoma, Texas, and Illinois). The 12-month implementation period started in January 2013 for centers in Cohort 1 and October 2013 for centers in Cohort 2. The claims of 1,828 patients with asthma from January 2012 to May 2015 were analyzed. The data included 12-month pre-program implementation, 12-month program implementation, and 5-month post-program completion periods.

RESULTS: The average number of asthma-related emergency room visits and hospitalizations decreased from 2.22 to 1.38 and 1.97 to 1.04 per 100 patients per month, respectively, in the 12-month pre-implementation period as compared to 12-month implementation period. The results of three-level generalized linear mixed models found that during the 12-month implementation period, patients had 37.7% and 47.1% lower rates of emergency room visits and hospitalizations, respectively, compared to the 12-month pre-implementation period ( p  < 0.001 in both comparisons).

CONCLUSIONS: Enhancing Care for Patients with Asthma is an effective quality improvement program that was successfully executed in diverse geographical states and associated with reductions in potentially preventable health events. The findings support the widespread use of the program in other settings.

Original languageEnglish (US)
Pages (from-to)874-882
Number of pages9
JournalJournal of Asthma
Volume58
Issue number7
Early online dateMar 27 2020
DOIs
StatePublished - 2021

Bibliographical note

Funding Information:
The authors would like to acknowledge the American Lung Association for initiating Enhancing Care for Patients with Asthma. The authors would like to thank Health Care Service Corporation for the provision of the administrative claims data used in this study.

Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.

Keywords

  • Asthma
  • disease management
  • emergency room visits
  • hospitalizations
  • pediatrics
  • preventable health care utilization
  • quality improvement

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study

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