- Community-based patient education programs can help improve asthma management, resulting in better patient knowledge of their condition, lower healthcare utilization, and lower overall healthcare costs, according to a recent study published in the American Journal of Managed Care.
According to a New York-based research team, uncontrolled asthma can be a costly and difficult issue. At Ellis Hospital in Schenectady, uncontrolled asthma accounted for nearly 900 emergency department visits in 2012, resulting in about $2 million in total costs.
The problem persists at a national level, with asthma issues accounting for 1.8 million total emergency department visits in 2011, equating to 1.3 percent of all ED visits.
“Asthma education (AE) programs are a cornerstone of asthma management,” the research team explained. “Education programs, when coupled with regular medical review, have repeatedly been shown to improve health outcomes for individuals with asthma and to reduce use of the ED.”
According to the researchers, community hospitals can create patient education programs to help meet patient chronic care needs while fostering better health outcomes and improving practice finances.
At Ellis Hospital, the researchers recruited 574 asthma patients for a six-month asthma education program. The program began with baseline measurements of hospital utilization and asthma control and knowledge. Upon their first visit, patients were also issued take-home educational materials.
During follow-up visits, patients completed asthma knowledge questionnaires, including the Asthma Control Test (ACT), the primary measure for asthma control knowledge in this study. Program administrators, including clinicians and respiratory therapists, also tracked asthma symptoms and reviewed educational materials with patients as needed.
These educational interventions produced overall positive results. Prior to intervention, patients scored an average of 14 on the Asthma Control Test, which the researchers categorized as poor asthma control. By the end of the study, those scores increased to 19. The researchers did not disclose the maximum score possible on this assessment.
Asthma knowledge also increased during the educational intervention, rising from an average score of 10 to 13. Again, the researchers did not disclose the maximum possible scores on this assessment.
Costly healthcare utilization also decreased. Twelve months prior to intervention, emergency department visits averaged at 1.1 visits per patient, and inpatient admissions at .16 per patient. At the end of the study, those numbers decreased to .4 and .06 visits and admissions per patient, respectively.
As a result, emergency department charges decreased by an estimated $600,000 and inpatient costs by $230,000 throughout the study.
These results highlight the importance of patient education in chronic disease management. When patients are more knowledgeable about their diseases, they can make better decisions about when to access care and how to better mitigate minor symptoms outside of the hospital.
“The decrease in symptoms has implications for improved quality of life and productivity,” the study explained. “Having a better understanding of the disease also leads to improved self-efficacy, confidence, and well-being.”
According to the researchers, equipping patients with this knowledge is a winning strategy for all stakeholders. Hospitals can reduce their emergency department volume and improve their financial bottom line. When patients have better control over their chronic conditions and achieve better health outcomes, they also benefit.
“Our work supports the observations of others and suggests that community-based AE programs can make a substantial contribution to the shared goal of the triple aim: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare,” the researchers concluded.
“Bettering patient well-being while simultaneously avoiding ED visits and decreasing costs is an attractive combination for providers, patients, insurance companies, and taxpayers alike.”