Role of Adult Asthma Education in Improving Asthma Control and Reducing Emergency Room Utilization and Hospital Admissions in an Inner City Hospital

Objective. Asthma education programs have been shown to decrease healthcare utilization and improve disease control and management. The purpose of our study was to evaluate the impact of an outpatient adult asthma education program in an inner city hospital caring for patients with low socioeconomic and educational status. Methods. An asthma education program was implemented in September 2014. Patients who received education from September 2014 to July 2015 were evaluated. Outcomes were compared for the same group of patients before and after education. Primary outcomes were emergency room (ER) visits and hospital admissions. Secondary outcomes were change in Asthma Control Test (ACT) score and number of pulmonary clinic visits. Results. Asthma education significantly decreased number of patients requiring ER visits and hospital admissions (p = 0.0005 and p = 0.0015, resp.). Asthma control as per ACT score ≥ 20 improved with education (p = 0.0001) with an increase in clinic visits (p = 0.0185). Conclusions. Our study suggests that implementation of a structured asthma education program in an inner city community hospital has a positive impact on reduction of ER visits and hospital admissions with improvement in asthma control. Institutional Review Board Clinical Study registration number is 01081507.

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Impact of Group Asthma Education on Asthma Control and Emergency Room Visits in an Underserved New York Community

Canadian Respiratory Journal ◽

10.1155/2019/5165189 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Asghar Ali ◽

Sybil Goday Pena ◽

Charnicia Huggins ◽

Franklyn Lugo ◽

Misbahuddin Khaja ◽

...

Keyword(s):

Health Care ◽

Inner City ◽

Emergency Room ◽

Asthma Control ◽

Test Scores ◽

City Hospital ◽

Emergency Room Visits ◽

Asthma Education ◽

Group Education ◽

Systemic Corticosteroids

Objective. Asthma education programs have been shown to be effective in decreasing health care utilization and improving disease control and management. However, there are few studies evaluating the outcomes of group asthma education. The aim of this study was to assess the impact of an outpatient adult group asthma education program in an inner-city-based hospital caring for an underserved population. Methods. We conducted a pre- and poststudy of all patients with asthma who participated in two structured group asthma education sessions led by a respiratory therapist, clinical pharmacist, and pulmonologist. The study period (January 2016 to April 2018) included the year before group education and the year after education. The primary outcomes were the number of patients requiring emergency room visits and hospital admission. The secondary outcomes included asthma control as assessed by Asthma Control Test scores, use of systemic corticosteroids, and change in test scores postintervention. Results. Eighty-eight patients received group education during the study period; 82 attended 2/2 sessions, and 6 attended 1/2 sessions. The study population was largely Hispanic (73%) or African American (25%) and had a mean age of 58 years. Most had moderate (57%) or severe (25%) persistent asthma. Significantly, fewer patients required emergency room visits in the postintervention period than in the preintervention period (20 visits vs. 42 visits, p=0.0002). Group education was also associated with increased asthma control (p=0.0043), decreased use of systemic corticosteroids (p=0.0005), and higher postintervention test scores (p=0.0001). Conclusions. Group asthma education provided by a multidisciplinary team in an inner-city hospital clinic caring for underserved and minority populations is feasible and may decrease utilization of health care resources when patients are educated and empowered to participate in their asthma management.

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Hospital admissions for hyperglycemic emergencies in young adults at an inner-city hospital

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2019.107869 ◽

2019 ◽

Vol 157 ◽

pp. 107869 ◽

Cited By ~ 1

Author(s):

Rachel A Wolf ◽

J. Sonya Haw ◽

Sudeshna Paul ◽

Melissa Spezia Faulkner ◽

EunSeok Cha ◽

...

Keyword(s):

Young Adults ◽

Inner City ◽

Hospital Admissions ◽

City Hospital

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The effect of a patient education program on emergency room use for inner-city children with asthma.

American Journal of Public Health ◽

10.2105/ajph.80.1.36 ◽

1990 ◽

Vol 80 (1) ◽

pp. 36-38 ◽

Cited By ~ 37

Author(s):

M C Shields ◽

K W Griffin ◽

W L McNabb

Keyword(s):

Patient Education ◽

Inner City ◽

Emergency Room ◽

Education Program ◽

Patient Education Program ◽

Children With Asthma

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Patient Education With Inhaler Technique to Prevent Readmissions and Emergency Room (ER) Visits in Asthma and COPD: A Quality Improvement Project at an Inner-City Hospital

CHEST Journal ◽

10.1016/j.chest.2016.08.724 ◽

2016 ◽

Vol 150 (4) ◽

pp. 632A

Author(s):

Ravneet Riar ◽

Leonel Carrasco ◽

Margaret Olibrice ◽

Raji Ayinla

Keyword(s):

Quality Improvement ◽

Patient Education ◽

Inner City ◽

Emergency Room ◽

Quality Improvement Project ◽

City Hospital ◽

Inhaler Technique ◽

Improvement Project

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Short-stay admissions at an inner city hospital: a cross-sectional analysis

Emergency Medicine Journal ◽

10.1136/emermed-2016-205803 ◽

2018 ◽

Vol 35 (4) ◽

pp. 238-246

Author(s):

Ian Pope ◽

Sharif Ismail ◽

Benjamin Bloom ◽

Gwyneth Jansen ◽

Helen Burn ◽

...

Keyword(s):

Inner City ◽

Hospital Admissions ◽

Binary Logistic Regression ◽

Clinical Decision ◽

City Hospital ◽

Short Stay ◽

Cross Sectional ◽

Discharge Data ◽

Inpatient Ward ◽

Sectional Analysis

ObjectiveTo investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs).MethodThis is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU. Variables included: age, gender, ethnicity, deprivation score, arrival date and time, arrival method, admission outcome and discharge diagnosis. Analysis was performed by cross-tabulation followed by binary logistic regression in three models using the outcome measures above and seeking to identify factors associated with short-stay admission.ResultsThere were 2119 (24%) admissions during the study period and 458 were admitted for less than 24 hours. Those who were admitted in the middle of the week or with ambulatory care sensitive conditions (ACSCs) were significantly more likely to experience short-stays. Older patients and those who arrived by ambulance were significantly more likely to have a longer hospital stay. There was no association of length of inpatient stay with being admitted in the last 10 min of a 4 hours ED stay.ConclusionOnly a few factors were independently predictive of short stays. Patients with ACSCs were more likely to have short stays, regardless of whether they were admitted to CDU or an inpatient ward. This may be a group of patients that could be targeted for dedicated outpatient management pathways or CDU if they need admission.

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