To test whether an audit facilitator could alter the pattern of diagnosis and treatment of childhood asthma.
Setting-12 general practices in Tayside.
Subjects-3373 children aged 1-15 inclusive who had symptoms suggestive of asthma or possible asthma drawn from a systematic review of 10 725 general practice case records.
Intervention-Children were targeted for a clinical review by their general practitioner or practice nurses.
Main outcome measures-Asthma related consultations, precriptions, hospital attendances, and health service costs 12 months before and after study.
Compared with controls (n=1563) the intervention group (n=1585) had more practice initiated consultations for asthma (relative risk 2.18 (95% confidence interval 1.74 to 2.73)), new diagnoses of asthma (2.83 (2.26 to 3.54)), and past diagnoses reaffirmed (1.30 (1.08 to 1.58)), and they were more frequently prescribed inhaled cromoglycate (1.52 (1.02 to 2.25)). Hospital inpatient day rates fell from 152 to 122 in the intervention group and rose from 69 to 117 in the control group between the year before and the year after study.
Total primary care costs rose from £30 118 to £37 243 in the intervention group and fell from £29131 to £27 990 in the control group.
Hospital care cost fell in the intervention group from £25 406 to £20 727 and rose in the control group from £12 699 to £19 650.
Mots-clés Pascal : Diagnostic, Résultat, Traitement, Homme, Enfant, Etude comparative, Asthme, Essai thérapeutique contrôlé, Médecin généraliste, Coût, Ecosse, Audit, Appareil respiratoire pathologie, Bronchopneumopathie obstructive, Grande Bretagne, Royaume Uni, Europe
Mots-clés Pascal anglais : Diagnosis, Result, Treatment, Human, Child, Comparative study, Asthma, Controlled therapeutic trial, General practitioner, Costs, Scotland, Respiratory disease, Obstructive pulmonary disease, Great Britain, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0248013
Code Inist : 002B30A03B. Création : 01/03/1996.