Hawaiian hospital’s pediatric asthma initiative cuts readmission rates

For a study appearing in Pediatrics, researchers took a look at the outcome measures of the Asthma Task Force changes implemented at the Kapi'olani Medical Center for Women and Children and University of Hawaii John A. Burns School of Medicine in Honolulu, Hawaii. They found that yes, not surprisingly, better patient adherence to treatment plans correlated with a significant reduction in readmission rates.

Lora Bergert, M.D., of the department of Pediatrics at the medical school and hospital, and her co-authors, examined the records of 2- to 18-year-old patients who were hospitalized with a primary diagnosis of asthma between January 1, 2008, and June 30, 2012. Of these, 231 records were from before the Asthma Task Force implemented three simple primary care measures for asthma management in children and teens. These were:

1. Use of a bronchodilator/reliever medication.
2. Taking corticosteroid (maintenance medication) as prescribed.
3. Completion of a home management plan of care that included a postdischarge appointment with a primary care provider and/or a physician name and contact number at discharge.

The pre-change patients were then compared to another 532 subjects who were hospitalized after the change was implemented in 2009.

They found the hospital effort to partner with primary care providers through the multi-disciplinary Asthma Task Force did seem to pay off. As compliance with the new care measures increased, readmission rates in the 3- to 6-month interval after the initial hospitalization dropped considerably, a result the researchers attributed to the “comprehensive set of interventions” designed by the Asthma Task Force.

Much of the readmission rate reduction work currently being done is focused on the Medicare eligible as Medicare has moved to penalize hospitals with high readmission rates for these beneficiaries. However, the Pediatrics study shows that progress can be made for all ages.