TY - JOUR
T1 - Improving childhood asthma outcomes in the United States
T2 - A blueprint for policy action
AU - Lara, Marielena
AU - Rosenbaum, Sara
AU - Rachelefsky, Gary
AU - Nicholas, Will
AU - Morton, Sally C.
AU - Emont, Seth
AU - Branch, Marian
AU - Genovese, Barbara
AU - Vaiana, Mary E.
AU - Smith, Vernon
AU - Wheeler, Lani
AU - Platts-Mills, Thomas
AU - Clark, Noreen
AU - Lurie, Nicole
AU - Weiss, Kevin B.
PY - 2002
Y1 - 2002
N2 - Background/Objective. Asthma is increasingly being recognized as an important public health concern for children in the United States. Effective management of childhood asthma may require not only improving guideline-based therapeutic interventions, but also addressing social and physical environmental risk factors. The objective of this project was to create a blueprint for improvement of national policy in this area. Design/Methods. A nominal group process with nationally recognized experts and leaders (referred to as "the committee") in childhood asthma. Results. The committee identified 11 policy recommendations (numbered in order below) in 2 broad categories: Improving Health Care Delivery and Financing, and Strengthening the Public Health Infrastructure. Recommendations regarding Improving Health Care Delivery and Financing include the development and implementation of quality-of-care standards in 1) primary care, 2) self-management education, and 3) case-management interventions, and the expansion of insurance coverage and benefit design by 4) extending continuous health insurance coverage for all children, 5) developing model insurance benefits packages for essential childhood asthma services, and 6) educating health care purchasers in how to use them. Recommendations for Strengthening the Public Health Infrastructure include public funding of asthma services that fall outside the insurance system through establishing 7) public health grants to foster asthma-friendly communities and 8) school-based asthma initiatives. 9) Launching a national asthma public education campaign, 10) developing a national asthma surveillance system, and 11) establishing a national agenda for asthma prevention research, with an emphasis on epidemiologic and behavioral sciences, are also recommended. Conclusions. Implementing these recommendations will require coordination of activities at the national, state, and local community level, and within and outside the health care delivery system. With a further commitment of national and local resources, implementation of these recommendations will likely lead to improved child and family asthma outcomes in the United States.
AB - Background/Objective. Asthma is increasingly being recognized as an important public health concern for children in the United States. Effective management of childhood asthma may require not only improving guideline-based therapeutic interventions, but also addressing social and physical environmental risk factors. The objective of this project was to create a blueprint for improvement of national policy in this area. Design/Methods. A nominal group process with nationally recognized experts and leaders (referred to as "the committee") in childhood asthma. Results. The committee identified 11 policy recommendations (numbered in order below) in 2 broad categories: Improving Health Care Delivery and Financing, and Strengthening the Public Health Infrastructure. Recommendations regarding Improving Health Care Delivery and Financing include the development and implementation of quality-of-care standards in 1) primary care, 2) self-management education, and 3) case-management interventions, and the expansion of insurance coverage and benefit design by 4) extending continuous health insurance coverage for all children, 5) developing model insurance benefits packages for essential childhood asthma services, and 6) educating health care purchasers in how to use them. Recommendations for Strengthening the Public Health Infrastructure include public funding of asthma services that fall outside the insurance system through establishing 7) public health grants to foster asthma-friendly communities and 8) school-based asthma initiatives. 9) Launching a national asthma public education campaign, 10) developing a national asthma surveillance system, and 11) establishing a national agenda for asthma prevention research, with an emphasis on epidemiologic and behavioral sciences, are also recommended. Conclusions. Implementing these recommendations will require coordination of activities at the national, state, and local community level, and within and outside the health care delivery system. With a further commitment of national and local resources, implementation of these recommendations will likely lead to improved child and family asthma outcomes in the United States.
KW - Childhood asthma
KW - Health care policy
KW - Health care services
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U2 - 10.1542/peds.109.5.919
DO - 10.1542/peds.109.5.919
M3 - Article
C2 - 11986457
AN - SCOPUS:18344385138
SN - 0031-4005
VL - 109
SP - 919
EP - 930
JO - Pediatrics
JF - Pediatrics
IS - 5
ER -