• Kenny Yat-Choi Kwong, Nasser Redjal, Lyne Scott, Marilyn Li, Salima Thobani, and Brian Yang.
• Los Angeles County+University of Southern California Medical Center, Division of Allergy-Immunology, Department of Pediatrics, 1801 East Marengo St, Rm 1G1, Los Angeles, CA 90033. E-mail: kkwongusc@yahoo.com.
• Am J Manag Care. 2017 Jul 1; 23 (7): e231-e237.

ObjectivesAsthma management programs, such as the Breathmobile program, have been extremely effective in reducing asthma morbidity and increasing disease control; however, their high start-up costs may preclude their implementation in smaller health systems. In this study, we extended validated asthma disease management principles from the Breathmobile program to a smaller clinic system utilizing existing resources and compared clinical outcomes.Study DesignCox-regression analyses were conducted to determine the cumulative probability that a new patient entering the program would achieve improved clinical control of asthma with each subsequent visit to the program.MethodsA weekly asthma disease management clinic was initiated in an existing multi-specialty pediatric clinic in collaboration with the Breathmobile program. Existing nursing staff was utilized in conjunction with an asthma specialist provider. Patients were referred from a regional healthcare maintenance organization and patients were evaluated and treated every 2 months. Reduction in emergency department (ED) visits and hospitalizations, and improvements in asthma control were assessed at the end of 1 year.ResultsA total of 116 patients were enrolled over a period of 1 year. Mean patient age was 6.4 years at the time of their first visit. Patient ethnicity was self-described predominantly as Hispanic or African American. Initial asthma severity for most patients, classified in accordance with national guidelines, was "moderate persistent." After 1 year of enrollment, there was a 69% and 92% reduction in ED/urgent care visits and hospitalizations, respectively, compared with the year before enrollment. Up to 70% of patients achieved asthma control by the third visit. Thirty-six different patients were seen during 1 year for a total of $15,938.70 in contracted reimbursements.ConclusionsA large-scale successful asthma management program can be adapted to a stationary clinic system and achieve comparable results.

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