Reduction in the number of asthma-related hospital admissions after the implementation of a multidisciplinary asthma control program in the city of Londrina, Brazil

J Bras Pneumol. 2008 Sep;34(9):639-45. doi: 10.1590/s1806-37132008000900002.
[Article in English, Portuguese]

Abstract

Objective: To evaluate the relationship between the reduction in the number of asthma-related hospital admissions and the changes occurring after the intervention performed in the health care system of the city of Londrina, Brazil.

Methods: In 2003, an intervention was performed in the local health care system (Family Health Clinics). The steps adopted were as follows: development of a protocol based on the III Brazilian Consensus on Asthma Management; access to free inhaled corticosteroids for patients; training of health professionals; and implementation of educational measures, especially for the community. The authorizations for hospital admissions of patients diagnosed with asthma alone between 2002 and 2005 in the city of Londrina were analyzed.

Results: The mean age was 14.3 +/- 0.5 years, without gender predominance. The number of hospital admissions fell more markedly in 2005 than in the previous years studied. This decline was more pronounced at the Family Health Clinics where professional training occurred earlier. The post-intervention (2004-2005) rate of asthma-related hospital admissions (120/100,000 inhabitants) was significantly lower than the pre-intervention (2002-2003) rate (178/100,000 inhabitants; p < 0.01).

Conclusions: The admission curve showed a tendency toward a reduction after 2003, and, aside from the intervention performed, no other factors that would explain the results obtained were identified. The rate at which the number of hospital admissions decreased was in direct proportion to the length of time elapsed since the intervention (greater decreases over time). We conclude that the intervention performed in the local health care system was responsible for the data presented.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Asthma / epidemiology
  • Asthma / prevention & control*
  • Asthma / therapy
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Health Personnel / education
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • National Health Programs / organization & administration*
  • Outcome and Process Assessment, Health Care
  • Patient Admission / statistics & numerical data*
  • Patient Admission / trends
  • Patient Care Team / organization & administration*
  • Patient Education as Topic
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • Sex Factors
  • Young Adult