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 studies focus on characterizing the risk factors leading up to the event. Others focus on follow-up care or patient outcomes after discharge. There have also been studies examining the impact of emergency department practices on the decision to admit and, more recently, reports on the advantages of standardized care processes—critical pathways—for improving asthma care and reducing costs during hospitalization. this
However, there appear to be no studies that have comprehensively examined the overall approaches to asthma care used by hospitals, including bedside care, asthma education activities, asthma quality improvement projects, and asthma outreach services.
The purpose of this study is to characterize the extent to which hospitals in the Chicago area have implemented various types of asthma-specific health-care delivery processes. These characteristics are of particular interest in light of the disproportionately high rate of asthma mortality in this large metropolitan community.
This study used a cross-sectional, self-administered survey of hospital asthma care as reported by a designated asthma expert within each of the hospitals.
Survey Instrument Development
A 98-item, self-administered survey instrument was developed to address the following areas: (1) use of asthma-specific policies or clinical practice guidelines; (2) selected inpatient asthma care practices; (3) selected outpatient asthma care practices; (4) asthma-specific quality improvement activities; and (5) asthma-related community outreach.