Mission Healthcare Foundation: Childhood Asthma Program Reduces ER Visits in Western North Carolina

By Heath Nettles

Mission Hospital’s Regional Asthma Disease Management Program and Mission Healthcare Foundation, in conjunction with the National Institute of Health’s National Asthma Control Initiative have completed a two-year program for rural Western North Carolina to address health disparities in minority children suffering from asthma.

Objectives for the initiative were to help young children manage their asthma and reduce/eliminate environmental irritants in homes and child care settings. The program drastically cut emergency room visits and saved more than $800,000.

The program targeted uninsured/underinsured children below 12 years of age and directed its outreach to mostly Native American, African American, and Hispanic children. It followed 50 children previously diagnosed with asthma.

The participants and their families were given care and education in non-traditional settings, such as homes, schools, and other facilities. Asthma disease management was provided under the direction of patients’ primary care providers and included clinical assessments, asthma education, trigger avoidance measures, medication reviews and the development customized Asthma Action Plans.

Environmental assessments were conducted in each home as well as participants’ schools or child care sites. Results were discussed with site/home owners and follow-ups were performed over the two-year program duration. 

The program’s ultimate goal was to improve a patient’s quality of life, decrease school absenteeism, and decrease emergency department utilization and/or inpatient visits – resulting in cost avoidance. An impact study of the program shows it reduced asthma related emergency room visits by 94 percent and hospitalizations by 95 percent. Combined, these resulted in a total of $829,483 in savings. Average school absences went from 17 to nine missed days.

Key collaborators of the program included the North Carolina Asthma Program, Asthma Alliance of North Carolina, Western North Carolina School Systems and Child Care Centers, North Carolina Department of Health And Human Services, North Carolina Department of Environmental and Natural Resources, The National Environmental Health Association, The National Center for Healthy Housing, WNC Primary Care Providers, Cherokee Indian Hospital Authority, satellite clinics, sub-specialists, school nurses, social workers, and case managers.

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