The Commonwealth Fund features Cincinnati Children’s Asthma Improvement Collaborative in a case study series of care management programs for its efforts to break the cycle of preventable hospital use among high-risk asthma patients.
Launched in 2008, the collaborative has enhanced the quality and coordination of asthma care for low-income, Medicaid-insured children in Hamilton County, Ohio, and lengthened the average time between hospital encounters by more than 100 days from May 2009 to January 2012. Hospital data also showed that a combined rate of 30-day readmissions or emergency department revisits for asthma fell by 50 percent among hospital patients in the target population between 2008 and 2011.
Hamilton County has an estimated 11,000 Medicaid-enrolled children, ages 2 to 17, who rely on Cincinnati Children’s for the majority of their asthma-related inpatient hospital care. Approximately 4,000 of these children see physicians and nurse practitioners in the medical center’s primary care clinics.
“It requires changing the mind-set for asthma care from ‘here are your breathing treatments and steroids’ to one where you look to see what can be initiated to alter the overall trajectory of care for the patient once they leave the hospital,” says Mona Mansour, MD, General and Community Pediatrics.
Improvements focused on consistently providing evidence-based asthma care in the hospital, reliably sharing critical information with the patient’s managed care organization and primary care clinic, improving access to medications to support treatment adherence following a hospitalization, enhancing patient and family self-care education, helping at-risk patients and their families remove environmental barriers to asthma control by strengthening ties to community resources, and using data to measure progress.
View the full case study here.