Clinical and Utilization Outcomes for a Pediatric and Adolescent Telephonic Asthma Care Support Program: A Propensity Score-Matched Cohort Study
Gregory D. Berg
Objective: To investigate the effect of an asthma care support program for patients under the age of 18 years. Study design: A 1 Patient groups: 318 asthma care support program participants and 318 matched non-participants. Main outcome measures: The rates of medical service utilization including rates of hospitalization, emergency department (ED) visits, and selected clinical indicators including allergen immunotherapy, chest x-rays, influenza vaccinations, and pneumococcal vaccinations. Results: Baseline matching resulted in no statistically significant difference between the treatment and matched cohorts. However, during the program period the treatment cohort had 35.6% fewer inpatient admissions (p = 0.045), 32.5% fewer ED visits (p = 0.007), 56.7% fewer asthma-related inpatient admissions (p = 0.008), 50.8% fewer asthma-related ED visits (p < 0.0001), 26.8% fewer chest x-rays (p = 0.036), and 51.6% more influenza immunizations (p = 0.046). Conclusions: Where controlled randomized clinical trials cannot be performed, the use of propensity scores provides an alternative for the purpose of estimating a treatment effect using observational data. The current study employed a propensity score-matching methodology to select a subset of comparison units most comparable to treatment units. It documented the beneficial clinical outcomes of pediatric and adolescent participation in an asthma care support program which suggested a beneficial impact of monitoring, education, and more rigorous adherence to action plans for program participants.
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