Telephone Case Management for Asthma: An Acceptable and Effective Intervention within a Diverse Pediatric Population

Abstract

Background. Asthma disproportionately affects low-income and medically underserved children; additional tools are needed in the effort to improve asthma care. Objectives. We reviewed the implementation of a telephone case management program provided by community health workers (CHWs) as an alternative to home visits, to examine its efficiency, acceptability, and capacity to identify and address challenges with asthma management. Methods. This retrospective cohort study included children (and their caregivers) presenting for scheduled visits to a comprehensive asthma clinic at an urban, public hospital during 2007. Results. Overall, 83.2% of caregivers were contacted for follow-up. Of those not reachable, one-third had been discharged from the clinic, and most of the remainder later returned for a subsequent visit. Latino patients were more likely not to be reached by telephone (p < .001). Following the implementation of telephone case management, the number of patient visits to the asthma clinic increased by almost one-third. Conclusions. Telephone case management identified problems which were successfully addressed through improved patient care practices and system changes within the clinic. Telephone case management by CHWs can be an efficient, acceptable mechanism to supplement comprehensive asthma care in a diverse, urban pediatric population.

• asthma
• pediatrics
• telephone case management
• underserved populations

Acknowledgments

We gratefully acknowledge the inputs of Andrea Martinez and Monica O'Dell and the editorial comments of Collin Partridge.

Declaration of Interest

The authors report no competing interests. The authors alone are responsible for the content and writing of this paper.