The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3296.0: Monday, November 17, 2003 - 3:32 PM

Abstract #66999

Kaiser Permanente pioneering methods in asthma for risk stratification and results

Guillermo Mendoza, MD, Department of Allergy, Kaiser Permanente Medical Offices, 3700 Vaca Valley Parkway, Vacaville, CA 95688, 707-453-5616,

While numerous interventions have proved efficacious in small trials, an outstanding strategic issue in chronic disease management is the difficulty of scaling up best practices absent in hothouse conditions. This presentation will discuss meeting this challenge in a large health maintenance organization that cares for one in four northern Californians. We will show how to build a business case by demonstrating that doing the right thing really is less expensive than doing the wrong thing over and over again. We will present the use of methods for risk stratification which is defined in three levels from the most high risk cases to the most well-controlled patients; Level 3: Intensive Care; Level 2: Assisted Care; Level 1: Self-Care. We will also present the use of asthma registries, tracking of pharmacy data, and employing clinical care coordinators to promote self-management. As a result of an adult asthma management program, from 1998 to 2001, the percent of primary care clinicians using prevention-oriented medication practices increased from 52% to 79%. From 1996 to 2000, the emergency visit rate declined from 10 per 100 persistent asthmatics to four. Finally, we will discuss the adaptation of these methods in safety net health systems through the YES WE CAN Toolkit and other efforts.

Learning Objectives:

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

Strategies for Addressing the Urban Asthma Crisis (Urban Health Contributed Papers)

The 131st Annual Meeting (November 15-19, 2003) of APHA