Reducing quality-of-care disparities in childhood asthma: La Red de Asma Infantil intervention in San Juan, Puerto Rico
| Autor: | Jesús A González-Gavillán, Beatriz Morales-Reyes, Heriberto Marín, Mario H Rodríguez-Sánchez, Marielena Lara, Herman Mitchell, Fernando López-Malpica, Gilberto Ramos-Valencia |
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| Rok vydání: | 2013 |
| Předmět: |
Gerontology
Male Child Health Services Psychological intervention Severity of Illness Index Cost Savings Intervention (counseling) Environmental health Severity of illness Medicine Humans Health Education Poverty Asthma Quality of Health Care business.industry Puerto Rico Emergency department Environmental Exposure Health Status Disparities Allergens medicine.disease Health equity Hospitalization Self Care Air Pollution Indoor Child Preschool Pediatrics Perinatology and Child Health Feasibility Studies Health education Female Health Expenditures business Emergency Service Hospital Monte Carlo Method Health care quality Follow-Up Studies |
| Zdroj: | Pediatrics. 131 |
| ISSN: | 1098-4275 |
| Popis: | BACKGROUND AND OBJECTIVEAlthough children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions.METHODS:We describe our experience in adapting and implementing 2 previously tested asthma evidence-based interventions: the Yes We Can program and the Inner-City Asthma Study intervention. We assessed the feasibility of combining key components of the 2 interventions to reduce asthma symptoms and estimated the potential cost savings associated with reductions in asthma-related hospitalizations and emergency department visits. A total of 117 children with moderate and severe asthma participated in the 12-month intervention in 2 housing projects in San Juan, Puerto Rico. A community-academic team with the necessary technical and cultural competences adapted and implemented the intervention.RESULTS:Our case study revealed the feasibility of implementing the combined intervention, henceforth referred to as La Red intervention, in the selected Puerto Rican communities experiencing a disproportionately high level of asthma burden. After 1-year follow-up, La Red intervention significantly reduced asthma symptoms and exceeded reductions of the original interventions. Asthma-related hospitalizations and emergency department use, and their associated high costs, were also significantly reduced.CONCLUSIONS:Asthma evidence-based interventions can be adapted to improve quality of care for children with asthma in a different cultural community setting. |
| Databáze: | OpenAIRE |
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