Archive for the 'Asthma' Category

05 Oct

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Conclusion

Although there are important limitations, this survey still provides new insights into the asthma care delivered by a large group of hospitals located in one geographical area. Several audits of hospital-based asthma care conducted outside of the United States have been published; however, these studies almost exclusively examine individual hospital performance rather than taking a […]

04 Oct

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Outcome

Asthma programs that include a home visit for follow-up after discharge have shown promise as effective strategies to reduce readmission. However, very few hospitals provide any type of asthma case management or home visit services. This lack of coordinating services at the hospital level is counter to the emerging interest of managed care to develop […]

03 Oct

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Discussion

In relation to the national guidelines, the Chicago-area hospitals responding to this survey appear to perform well, especially in providing bedside services such as nebuliza-tion therapy, patient instruction on peak flow monitoring, and evaluation of inhaler technique. However, just over half of the hospitals routinely provide asthma education to patients prior to discharge. In the […]

02 Oct

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Asthma-Specific Quality Improvement Activities and Community Outreach

Asthma-Specific Quality Improvement Activities and Community Outreach Approximately 58% of the hospitals indicated that they conducted utilization review for diagnoses of asthma in both the inpatient and outpatient settings. However, as seen in Table 2, the hospitals with practice guidelines for inpatient asthma management were much more likely to conduct utilization review (p < 0.01). Just […]

01 Oct

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Characteristics of Outpatient Settings

There were no differences between academic and nonacademic institutions in use of guidelines, critical pathways, or other asthma services. Urban vs suburban location was significant for only one aspect of hospital asthma care—ICU-specific asthma care policies or guidelines. Where 30.8% of urban hospitals had ICU guidelines, only 9.1% of the suburban hospitals had them (p […]

30 Sep

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Results

Twenty-six percent of the responding hospitals had policies or guidelines specifically for management of asthma in the ICU, and another 5.2% were in the process of developing them. Only 18.6% of these hospitals had asthma-specific critical pathways for the ICU, and another 8.5% reported that critical pathways were in development. The survey also explored four […]

29 Sep

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Statistical Analysis

Subanalyses were conducted to determine the relationships between hospitals that were (1) urban vs suburban, (2) academic vs nonacademic, and (3) those reported to use asthma practice guidelines vs those that were not. Hospitals were classified as urban if they were located within the city of Chicago (based on postal zones), and suburban if they […]

28 Sep

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Study Population

Study Population Hospitals in the six-county Chicago area (including Cook, DuPage, Kane, Lake, McHenry, and Will counties) were identified from the membership list of the American Hospital Associ-ation. Of the 107 hospitals identified from this source, psychiatric and military hospitals were excluded, leaving a study population of 89 eligible hospitals. Data Collection The survey was […]

27 Sep

Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area

Results From the Chicago Asthma Surveillance Initiative Asthma accounts for > 450,000 hospitalizations annually in the United States. These hospital visits have a significant impact on Untied States health-care expenditures, accounting for an estimated $1.6 billion annually. Much of the literature in this area is based on the premise that most asthma hospitalizations are preventable. Therefore, these […]

15 May

Peak Expiratory Flow Rates in Possible Occupational Asthma (18)

The implications of the suggestion by Josephs and colleagues, if confirmed, include that histamine or methacholine hyperresponsiveness may not necessarily be present for the diagnosis of currently symptomatic asthma, in contrast to earlier reports. This could conceivably account for the low specificity that we observed in the present study. Perhaps the objective criteria suggesting no […]

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