EFFECTIVENESS OF A SPECIALIZED ASTHMA CLINIC IN REDUCING ASTHMA MORBIDITY IN AN INNER-CITY MINORITY POPULATION

Asthma is the most common chronic disease of childhood and a leading c ause of morbidity in adults. Despite significant advances in medical t herapy, asthma morbidity and mortality rates have risen dramatically o ver the past two decades, especially in minority and socioeconomically disadvantaged populations. Numerous intervention programs have been d esigned in an attempt to reduce asthma morbidity but few have targeted poor or minority populations. The purpose of this study was to assess whether an outpatient intervention program specifically targeted at a high-minority population in East Harlem, in New York City, was succes sful in reducing asthma morbidity. A retrospective chart review of 84 patient records was conducted. The patients were divided into two grou ps, an intervention group (n = 45), who were followed by an asthma spe cialist (allergist/immunologist), and a nonintervention group, followe d by a general internist or pediatrician. Outcome variables including clinic walk-in visits, emergency room visits, and hospitalizations wer e determined and compared in the pre- and postintervention period in b oth groups. Patients in the intervention group had reduced total walk- in visits (73 vs. 27, p < 0.001), emergency room visits (30 vs. 5, p < 0.001), and hospitalizations (16 vs. 2, p < 0.001). In contrast, pati ents in the nonintervention group had no change in total walk-in visit s (88 vs. 72), increased emergency visits (7 vs. 22, p < 0.05), and no change in hospitalizations (5 vs. 2), respectively. The outpatient in tervention program has been successful in reducing asthma morbidity in the high-risk minority community of East Harlem. Future larger studie s are warranted to extend this pilot program to other high-risk minori ty populations.