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 < 0.05). There were no significant differences among the academic vs nonacademic hospitals for this aspect of care. fully
Characteristics of Outpatient Settings
Many of the responding hospitals indicated they also deliver outpatient primary care: 40.7% had a general medicine clinic, 30.5% had a family practice clinic, and 32.2% had a pediatric clinic. Nearly 56% of the family medicine clinics were reported to use asthma care guidelines, and 27.8% provided 24-h telephone management for asthma patients. Of the pediatric clinics, 31.6% were reported to use asthma care guidelines, and 26.3% provided 24-h telephone management for asthma patients. Approximately 20% of the general medicine clinics reported using asthma care guidelines, and 25.0% provided 24-h telephone access.
Approximately 20% of the hospitals indicated they had outpatient asthma specialty clinics. Of these specialty clinics, 72.7% provided allergy services, 90.9% provided pulmonary services, and 36.4% provided 24-h telephone access to asthma specialists.
In the outpatient setting, 53.1% of the hospitals reported the ability to provide nebulization therapy, 76.0% of the hospitals routinely provided peak flow monitoring and peak flow instruction, and 88.0% reported routinely providing instruction on inhaler technique. Nearly 36% of the hospitals indicated they conducted formal asthma education programs in the outpatient setting. “Wee wheezers” and “Airpower” were the most common programs used by these hospitals.