Building a regional pediatric asthma learning health system in support of optimal, equitable outcomes.

Autor:	Beck AF; Division of General & Community Pediatrics Cincinnati Children's Cincinnati Ohio USA.; Division of Hospital Medicine Cincinnati Children's Cincinnati Ohio USA.; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA.; Michael Fisher Child Health Equity Center Cincinnati Children's Cincinnati Ohio USA.; Office of Population Health Cincinnati Children's Cincinnati Ohio USA.; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA., Seid M; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA.; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA.; Division of Pulmonary Medicine Cincinnati Children's Cincinnati Ohio USA., McDowell KM; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA.; Division of Pulmonary Medicine Cincinnati Children's Cincinnati Ohio USA., Udoko M; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA.; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA.; Division of Pulmonary Medicine Cincinnati Children's Cincinnati Ohio USA., Cronin SC; Division of Pulmonary Medicine Cincinnati Children's Cincinnati Ohio USA., Makrozahopoulos D; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA., Powers T; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA., Fairbanks S; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA., Prideaux J; Division of Emergency Medicine Cincinnati Children's Cincinnati Ohio USA.; Qualitative Methods & Analysis Collaborative Cincinnati Children's Cincinnati Ohio USA., Vaughn LM; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA.; Division of Emergency Medicine Cincinnati Children's Cincinnati Ohio USA.; Qualitative Methods & Analysis Collaborative Cincinnati Children's Cincinnati Ohio USA.; Criminal Justice, & Human Services University of Cincinnati College of Education Cincinnati Ohio USA., Hente E; UC Health Cincinnati Ohio USA., Thurmond S; Department of Information Services Cincinnati Children's Cincinnati Ohio USA., Unaka NI; Division of Hospital Medicine Cincinnati Children's Cincinnati Ohio USA.; James M. Anderson Center for Health Systems Excellence Cincinnati Children's Cincinnati Ohio USA.; Michael Fisher Child Health Equity Center Cincinnati Children's Cincinnati Ohio USA.; Office of Population Health Cincinnati Children's Cincinnati Ohio USA.; Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA.
Jazyk:	angličtina
Zdroj:	Learning health systems [Learn Health Syst] 2023 Dec 11; Vol. 8 (2), pp. e10403. Date of Electronic Publication: 2023 Dec 11 (Print Publication: 2024).
DOI:	10.1002/lrh2.10403
Abstrakt:	Introduction: Asthma is characterized by preventable morbidity, cost, and inequity. We sought to build an Asthma Learning Health System (ALHS) to coordinate regional pediatric asthma improvement activities. Methods: We generated quantitative and qualitative insights pertinent to a better, more equitable care delivery system. We used electronic health record data to calculate asthma hospitalization rates for youth in our region. We completed an "environmental scan" to catalog the breadth of asthma-related efforts occurring in our children's hospital and across the region. We supplemented the scan with group-level assessments and focus groups with parents, clinicians, and community partners. We used insights from this descriptive epidemiology to inform the definition of shared aims, drivers, measures, and prototype interventions. Results: Greater Cincinnati's youth are hospitalized for asthma at a rate three times greater than the U.S. average. Black youth are hospitalized at a rate five times greater than non-Black youth. Certain neighborhoods bear the disproportionate burden of asthma morbidity. Across Cincinnati, there are many asthma-relevant activities that seek to confront this morbidity; however, efforts are largely disconnected. Qualitative insights highlighted the importance of cross-sector coordination, evidence-based acute and preventive care, healthy homes and neighborhoods, and accountability. These insights also led to a shared, regional aim: to equitably reduce asthma-related hospitalizations. Early interventions have included population-level pattern recognition, multidisciplinary asthma action huddles, and enhanced social needs screening and response. Conclusion: Learning health system methods are uniquely suited to asthma's complexity. Our nascent ALHS provides a scaffold atop which we can pursue better, more equitable regional asthma outcomes. Competing Interests: The authors state that they have no conflicts of interest to declare. (© 2023 The Authors. Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan.)
Databáze:	MEDLINE
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