 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Shannon Thyne, MD, Children's Health Center, San Francisco General Hospital, 1001 Potrero Ave., San Francisco, CA 94110, 415-206-3085, ShannonT@medSch.ucsf.edu
The purpose of this presentation is to describe the preliminary results of a program of community-based primary care targeting five asthma risk-factors that complicate asthma management in children with moderate-to-severe persistent asthma in low-income communities. Risk factors include poor coordination and follow-up among hospitals, emergency departments and primary care physicians; inadequate access to high quality medical care; lack of patient education on asthma management; sub optimal family living circumstances that undermine adherence to treatment plans; and patient exposure to indoor allergens and irritants. YES WE CAN is a demonstration project to improve asthma care for children. The YES WE CAN model makes it easy for clinics to “do the right thing.” YES WE CAN performs Community Clinic site visits by an asthma champion doctor and nurse to provide education and updates annually. Supplies, including spacers, bed/pillow covers, medicine boxes, peak flow meters, devices, health education materials in three languages, and cue cards and posters are also provided. Feedback on clinicians’ medication prescribing patterns are monitored, and asthma action plans are administered to clients. At the first demonstration site at SF General Hospital Pediatric Asthma Clinic, the largest provider of asthma care for low income children in our county, preliminary evaluation shows dramatic improvements in intermediate outcome measures such as use of written asthma action plans (increase from zero to 100% pre and post an intervention year), reported use of mattress covers (from zero to 88%) and use of preventive medication (increase from 40% to 83%). In tandem, utilization measures have improved markedly: hospitalization dropped from 21% to 4%, and ED visits dropped from 63% to 32%. We have similar results from a second-generation demonstration site at the Mission Neighborhood Health Center. We are currently ramping up an asthma program at Excelsior Clinic.
Learning Objectives:
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment