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School-Based Asthma Program Improves Health Indicators and Utilization

An asthma control effort, called the School-Based Asthma Therapy (SBAT) Program, reduced health care utilization and achieved substantial organic growth and high program acceptance by school staff, parents and providers.

“We adopted a program that was originally started as a research endeavor elsewhere. But we took it a step further, getting a local school system to work with us so we could orchestrate it in a way that was sustainable,” says Elizabeth Allen, MD, a pulmonologist at Nationwide Children’s Hospital and lead author of a program study, published in the Journal of Asthma.

“School nurses very enthusiastically received the program, because they saw the kids they had been trying to help were actually getting better in front of their eyes.” – Elizabeth Allen, MD

The resulting SBAT Program is funded by Partners For Kids, an accountable care organization (ACO) that functions as a partnership between Nationwide Children’s and 1,000 doctors in 34 Ohio counties. The ACO’s funding enables SBAT Program staff to coordinate services and communication with insurers, families, schools and physicians to get at-risk children asthma medication they need.

Participating school nurses and physicians identify children struggling with poorly controlled asthma that may be corrected by better adherence to inhaled corticosteroid controller medications. Enrolled children receive at least one daily preventative dose at school.

This simple step resulted in improvement in participants’ mean Asthma Control Test scores from 16 to 21 while their emergency department visits dropped by half and inpatient hospitalization days by three-quarters.

“School nurses very enthusiastically received the program, because they saw the kids they had been trying to help were actually getting better in front of their eyes,” says Dr. Allen, who is also the physician lead for Nationwide Children’s Keep Me Well Asthma Quality Improvement Initiative. “Providers also tell me their toughest patients are doing a lot better now.”

Based on savings from fewer emergency department visits and inpatient days, the SBAT Program largely pays for itself within the Partners For Kids ACO model. Initially provided to 38 students in 17 schools, enrollment is now nearly 500 children in more than 200 schools and growing.

Nationwide Children’s staff seeks funding to analyze the program’s impact on school absence, caregiver work absence and more as well as develop a guide to implement the SBAT Program.

CITATION:
Allen ED, Arcoleo K, Rowe C, Long WW. Implementation of a ‘real world’ School-Based Asthma Therapy program targeting urban children with poorly controlled asthma. Journal of Asthma. 2017 Nov 30:1-9. [E-pub ahead of print]

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