Impact of asthma intervention in two elementary school-based health centers in the Bronx, New York City.
Impact of asthma intervention in two elementary school-based health centers in the Bronx, New York City.
复制标题
哮喘干预对纽约市布朗克斯区两个小学健康中心的影响。
DOI：
10.1002/ppul.20307
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发表时间：
2005
影响因子：
3.1
通讯作者：
Appel,David
中科院分区：
文献类型：
--
作者：
Webber,MayrisP;Hoxie,Anne-MarieE;Odlum,Michelle;Oruwariye,Tosan;Lo,Yungtai;Appel,David
这项研究考察了纽约州布朗克斯市患有哮喘的学童随着时间的推移对医疗保健的利用情况，这些学童之前是通过六所小学的家长调查确定的。其中四所学校有现场校本卫生中心(SBHC)，两所没有现场卫生服务(对照学校)。在基线时，我们报告哮喘患病率为20%，前一年急诊室使用率较高(46%)。为了确定是否可以通过在两所有SBHC的学校实施积极的干预措施来降低哮喘发病率(特别是ED的使用、社区提供者的使用和哮喘的住院)，我们前瞻性地对儿童进行了长达3年的跟踪调查。家长计划每6个月进行一次访谈，并询问他们的孩子在过去6个月内对哮喘健康服务的使用情况。在多变量模型中，与对照学校的儿童相比，两个干预学校的儿童在过去6个月中去社区哮喘提供者(相对比率比0.52；95%可信区间(CI)0.30-0.88)或哮喘急诊科(优势比0.44；95%可信区间0.14-1.38；P= 0.059)的可能性较小。在参加非干预性SBHC和对照学校的儿童中，社区提供者使用或急诊科使用哮喘的情况没有差异。然而，学校类型并不影响哮喘住院率，所有组的住院率都有所下降。我们的研究结果支持学校健康中心提供积极的校本哮喘服务，以减少哮喘发病率和补充社区卫生服务的有效性。儿科肺单醇。©2005 Wiley-Liss Inc.
This study examines healthcare utilization over time in Bronx, New York schoolchildren with asthma who were previously identified via parent surveys in six elementary schools. Four of the schools have on‐site school‐based health centers (SBHCs), and two do not have on‐site health services (control schools). At baseline, we reported an asthma prevalence of 20%, and high rates of emergency department (ED) use (46%) in the previous year. To determine if asthma morbidity (specifically, ED use, community provider use, and hospitalizations for asthma) could be reduced by incorporating an aggressive intervention at two schools with SBHCs, we prospectively followed children for up to 3 years. Parents were scheduled for interviews every 6 months, and were queried about their children's use of health services for asthma in the prior 6 months. In multivariate models, children in the two intervention SBHC schools were less likely to have visited a community provider for asthma (relative rate ratio, 0.52; 95% confidence interval (CI), 0.30–0.88) or an emergency department for asthma (odds ratio, 0.44; 95% CI, 0.14–1.38;P= 0.059) in the prior 6 months compared to children attending control schools. There was no difference in community provider use or emergency department use for asthma between children attending nonintervention SBHCs and control schools. However, school type did not affect asthma hospitalization rates, which declined in all groups. Our findings support the effectiveness of aggressive school‐based asthma services provided by SBHCs to reduce asthma morbidity and complement community health services. Pediatr Pulmonol. © 2005 Wiley‐Liss, Inc.