Association of a School-Based, Asthma-Focused Telehealth Program With Emergency Department Visits Among Children Enrolled in South Carolina Medicaid
2020; American Academy of Pediatrics; Volume: 146; Issue: Supplement_4 Linguagem: Inglês
10.1542/peds.2020-023861zzz
ISSN1098-4275
Autores Tópico(s)Primary Care and Health Outcomes
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AAP Policy SupplementsSupplements Publish Supplement MultimediaVideo Abstracts Pediatrics On Call Podcast Subscribe Alerts Careers We will not be accepting article comments until November 8, 2021, while our site undergoes major changes. We apologize for the inconvenience. For questions, contact the editorial office. Asthma Association of a School-Based, Asthma-Focused Telehealth Program With Emergency Department Visits Among Children Enrolled in South Carolina Medicaid Julie D. Flom and Julie Wang Pediatrics December 2020, 146 (Supplement 4) S369-S370; DOI: https://doi.org/10.1542/peds.2020-023861ZZZ Julie D. Flom New York, New YorkFind this author on Google ScholarFind this author on PubMedSearch for this author on this siteJulie Wang New York, New YorkFind this author on Google ScholarFind this author on PubMedSearch for this author on this site ArticleInfo & MetricsComments Download PDF J Bian, KK Cristaldi, AP Summer. JAMA Pediatrics. 2019;61(3):1177–1183PURPOSE OF THE STUDY:To determine if access to school-based telehealth for children in a medically underserved community impacted number of all-cause emergency department (ED) visits, overall and among children with asthma.STUDY POPULATION:Children age 3–17 years who were enrolled in Medicaid residing in 5 counties in South Carolina from 2012–2017. Participants were part of a natural experiment, in which a school-based telehealth program was implemented from 2015–2017 in one county (Williamsburg) but was not implemented in four neighboring counties, which served as the control. The final sample included 23 198 children from Williamsburg and 213 164 children from surrounding counties contributing a total 2 443 405 child-months.METHODS:The authors used Medicaid claims data. The main exposure of interest was access to the telehealth program. The outcome was difference in rate of all-cause ED visits prior to (2012–2015) and after (2015–2017) implementation of the program in Williamsburg compared with the difference in rate in the four surrounding counties over the same time period. The authors adjusted for age, race/ethnicity, sex and fixed effects (to account for differences by county and temporal changes). Analysis was then performed in the subgroup of children with asthma.RESULTS:Rate of all-cause ED visits was not different between the groups. However, among children with a diagnosis of asthma, access to school-based telehealth was associated with a statistically significant reduction in all-cause ED visits (a 21% relative decrease). This was only significant in the third year after implementation of the program. In the full sample, the program was associated were fewer all-cause ED visits among children age 8–12 and among white compared with African American children.CONCLUSIONS:The authors conclude that there was a benefit of school-based telehealth for children with asthma from underserved areas. Benefits may extend to other chronic diseases and may be driven by improved monitoring and treatment modifications, adherence, involvement of trained nurses, and reimbursement through Medicaid. The program took 3 years to have a significant impact.REVIEWER COMMENTS:There are limited data on impacts of telehealth programs in pediatric patients, and the authors used a novel design to address this important question that is challenging to study. The study, performed in a medically underserved population, demonstrates that school-based telehealth initiatives have the potential to improve health outcomes in children. The coronavirus disease pandemic, which has broadly restricted access to pediatric care for both well-child care and chronic disease management, has highlighted the need for integrating telehealth-based care into pediatrics. This study demonstrates a potential benefit, although more information is needed to identify which subgroups stand to benefit the most and why, and to modify programs to extend benefits across age and race and ethnicity as well as to home-based telemedicine.Copyright © 2020 by the American Academy of Pediatrics PreviousNext Back to top Advertising Disclaimer » In this issue Pediatrics Vol. 146, Issue Supplement 4 1 Dec 2020 Table of ContentsIndex by author View this article with LENS PreviousNext Email Article Thank you for your interest in spreading the word on American Academy of Pediatrics.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. 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Or Sign In to Email Alerts with your Email Address Email * Citation Tools Association of a School-Based, Asthma-Focused Telehealth Program With Emergency Department Visits Among Children Enrolled in South Carolina Medicaid Julie D. Flom, Julie Wang Pediatrics Dec 2020, 146 (Supplement 4) S369-S370; DOI: 10.1542/peds.2020-023861ZZZ Citation Manager Formats BibTeXBookendsEasyBibEndNote (tagged)EndNote 8 (xml)MedlarsMendeleyPapersRefWorks TaggedRef ManagerRISZotero Share Association of a School-Based, Asthma-Focused Telehealth Program With Emergency Department Visits Among Children Enrolled in South Carolina Medicaid Julie D. Flom, Julie Wang Pediatrics Dec 2020, 146 (Supplement 4) S369-S370; DOI: 10.1542/peds.2020-023861ZZZ Share This Article: Copy Print Download PDF Insight Alerts Table of Contents Jump to section ArticlePURPOSE OF THE STUDY:STUDY POPULATION:METHODS:RESULTS:CONCLUSIONS:REVIEWER COMMENTS:Info & MetricsComments Related ArticlesNo related articles found.Google Scholar Cited By...No citing articles found.Google Scholar More in this TOC SectionAsthma Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen Lung Computational Models and the Role of the Small Airways in Asthma Increased Capsaicin Sensitivity in Patients With Severe Asthma Is Associated With Worse Clinical Outcome Show more Asthma Diagnosis and Management Telehealth Delivery of Adherence and Medication Management System Improves Outcomes in Inner-City Children With Asthma Association Between Fungal Spore Exposure in Inner-City Schools and Asthma Morbidity The Projected Economic and Health Burden of Uncontrolled Asthma in the United States Show more Diagnosis and Management Similar Articles Journal Info Editorial Board Editorial Policies Overview Licensing Information Authors/Reviewers Author Guidelines Submit My Manuscript Open Access Reviewer Guidelines Librarians Institutional Subscriptions Usage Stats Support Contact Us Subscribe Resources Media Kit About International Access Terms of Use Privacy Statement FAQ AAP.org shopAAP Follow American Academy of Pediatrics on Instagram Visit American Academy of Pediatrics on Facebook Follow American Academy of Pediatrics on Twitter Follow American Academy of Pediatrics on Youtube RSS © 2021 American Academy of Pediatrics
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