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 comprehensive disease management strategies for this chronic illness. One potential goal could be the partnering of Chicago-area hospitals and managed care plans for better coordinated and more comprehensive asthma management programs.
This survey also revealed the lack of hospital efforts to reach out to the surrounding community. Less than half of the respondents indicated their hospital had any type of community-based asthma program. Community-based hospital activities are quite common in other areas of health care, such as immunizations, disease screening (eg, cancer, diabetes), and health promotion activities. Expansion of these programs among the Chicago-area hospitals would seem essential if there is to be any community-wide effort to address the public health impact of asthma. read more
As with all studies, it is important to recognize the limitations of the study design and analysis when interpreting the results. This study was based on selfreported perception of asthma-related activities, some of which are not easily verified by direct observation or chart audit. While it is not possible to determine the true impact of this type of reporting bias, at least one study suggests that positive or socially preferred behaviors tend to be overestimated in self-reported data. Also, while the survey process sought to identify the person most knowledgeable about asthma care practices at each of the hospitals, any of the institutions might have had a more optimal person to query regarding this specific topic.