Colorado Asthma Toolkit Implementation Improves Some Process Measures of Asthma Care

Journal of the American Board of Family Medicine: JABFM

Laura Helmkamp^1¹  Bethany M. Kwan^1²  Bruce G. Bender^1³  Lisa M. Schilling^1⁴  Kathryn L. Colborn^1⁵ 

[1] Adult & Child Consortium for Health Outcomes Research & Delivery Science, Aurora, CO (LH);Department of Medicine, University of Colorado School of Medicine, Aurora (BMK, LMS);Department of Pediatrics, National Jewish Health, Denver (BGB);Pediatrics, University of Colorado School of Medicine, Aurora (MRS)^1;From the Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado (KLC)

关键词: Asthma;    Colorado;    Outcomes Assessment;    Primary Health Care;   

DOI  :  10.3122/jabfm.2019.01.180155

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Background: The Colorado Asthma Toolkit Program (CATP) has been shown to improve processes of care with less evidence demonstrating improved outcomes. Objective: To model the association between pre-and-post-CATP status and asthma-related process and outcome measures among patients ages 5 to 64 years receiving care in safety-net primary care practices. Methods: This is an implementation study involving secondary prepost analysis of existing structured clinical, administrative, and claims data. Nine primary care practices in a federally qualified health center network implemented the CATP. Processes of care and health and utilization outcomes were evaluated prepost implementation in a cohort of patients with asthma using generalized linear mixed models. Results: The study cohort included 2678 patients age 5 to 64 years with at least one visit to one of the 9 participating practices during the study period (March 12, 2010 to December 1, 2012). A comparison of 12 months pre- and post-CATP implementation showed improvement in some process measures of asthma care associated with the intervention, including the rate of asthma-severity measurement, although no change in 2 Health care Effectiveness Data and Information Set measures: asthma medication ratio and medication management for people with asthma. We also found no change in asthma outcomes measured across multiple domains: exacerbations, utilization, symptom scores, and pulmonary physiology measures. Conclusions: Implementation of the CATP in a primary care setting led to some improved processes of asthma care, but no changes in measured outcomes. Recommendations for future work include supplemental follow-up training including case review.

【 授权许可】

CC BY