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APHA Scientific Session and Event Listing

Tejal Mehta, MD¹, Sanjay Mitra, MD¹, Gladys Raveneau, MD¹, Anthony Divittis, MA², Evelyn Opoku, MD¹, Edward Fishkin, MD³, and Mitchell Rubin, MD¹. (1) Department of Pediatrics, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, 718-963-8779, Tejal.Mehta@woodhullhc.nychhc.org, (2) Business Affairs, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, (3) Medical Director, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206

Pediatric asthma, despite therapeutic advances, remains the most common chronic disorder in children and adolescents. This is amplified in the lowest income neighborhoods of New York City, where its prevalence rate approaches 25% and is the leading cause of childhood hospitalizations. In order to better treat chronic illness, a number of programs have been developed. One strategy, the Chronic Care Model, incorporating links to community resources, organization of health care, self-management support, delivery system design, decision support and clinical information systems, has recently been implemented at New York City's Health and Hospitals Corporation. One member, Woodhull Medical Center, serving poor, multi-ethnic communities where asthma rates near 30%, rolled this model into their comprehensive, family-centered asthma clinic. The “asthma team” consists of a physician, nurse assistant, public health educator and social worker. 60 pediatric asthmatic patients, identified as emergency room “high users,” with a mean age 7.5 years, participated in planned visits over a one year period. This intervention had a significant (p<0.0005) impact upon the process measures of asthma severity assessment, prescription of appropriate severity-based medications, initiation of asthma action plan and self-management goals. In addition, the outcome indicator of emergency room visits per patient month was reduced by 36.85% (p=0.08) - an average of 0.0991 emergency room visits per patient month pre-intervention and 0.0610 post-intervention was achieved. This unique program is considered to be a best practice model in New York's public hospital system.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to
• Articulate the six components of the Chronic Care Model
• Cite four process measures utilized in effective asthma care

Keywords: Asthma, Management

Presenting author's disclosure statement:

Not Answered