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The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project
- Source :
- Journal of Asthma. 52:881-888
- Publication Year :
- 2015
- Publisher :
- Informa UK Limited, 2015.
-
Abstract
- A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI).This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management.Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021.The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.
- Subjects :
- Male
Rural Population
Pulmonary and Respiratory Medicine
Low income
Environment
Severity of Illness Index
Patient Education as Topic
Nursing
Intervention (counseling)
Environmental health
Asthma control
Absenteeism
North Carolina
Humans
Immunology and Allergy
Medicine
Community Health Services
Disease management (health)
Child
Poverty
Asthma
business.industry
Racial Groups
Disease Management
medicine.disease
Respiratory Function Tests
respiratory tract diseases
Child, Preschool
Pediatrics, Perinatology and Child Health
Female
Observational study
Health Expenditures
Emergency Service, Hospital
business
Subjects
Details
- ISSN :
- 15324303 and 02770903
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Journal of Asthma
- Accession number :
- edsair.doi.dedup.....6a55b1a53c6947b20e97c9a666cac985