The purpose of the present study was to investigate whether criteria associated with assignment of asthma patients between general practice (GP) care alone, integrated care (shared between GP care and hospital clinic) or conventional specialist review could be identified, and whether outcomes for these patients differed over the next 12 months.
Seven hundred and sixty four patients with a diagnosis of asthma and previously assigned to either integrated care or clinic care were reviewed after 1 year and reassigned.
These patients were then followed for another 12 months and clinical data were collected over this time.
After 12 months in clinic care or integrated care, assignment to integrated care was predicted by previous participation in integrated care (OR 2.94), patient preference for integrated care (OR 3.7), no admission (OR 1.56), fewer steroid courses during the previous year (OR 0.88) and nonattendance at review (OR 0.43) in the previous 12 months.
Patient discharge to GP care was predicted by higher level of forced expiratory volume in one second (FEVI) (OR 1.49), lower number of GP consultations for troublesome asthma (OR 0.78), and nonattendance for review in the preceding year (OR 2.15).
In the following 12 months, the three groups of patients differed significantly in hospital admissions (Discharged=0.008 ; Integrated=0.12 ; Clinic=0.31), bronchodilators prescribed (Discharged=8.5 ; Integrated=10.2 ; Clinic=13.9), GP consultations (Discharged=...
Mots-clés Pascal : Asthme, Médecin généraliste, Spécialité médicale, Organisation santé, Traitement, Homme, Appareil respiratoire pathologie, Bronchopneumopathie obstructive
Mots-clés Pascal anglais : Asthma, General practitioner, Medical specialty, Public health organization, Treatment, Human, Respiratory disease, Obstructive pulmonary disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0212415
Code Inist : 002B11B. Création : 199608.