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Asthma nurse practice improves outcomes and reduces costs in primary health care
Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Pulmonary Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
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2002 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, 73-78 p.Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this study was to elucidate the care of patients with asthma in primary health care from medical, patient self-management, health, quality of live, and health economic perspectives.

Methods. Asthma nurse practice (ANP), an alternative asthma self-management strategy, was compared with traditional asthma care in primary health care in southern Sweden regarding medical history, lifestyle, self-management, symptoms caused by asthma, effects on sick leave, state of health, quality of life and health care costs. The first part of the investigation comprised a retrospective study of a randomly selected sample of patient records of asthmatics (n=152). The second part, lasting 3 months, was prospective and included consecutive patients visits (n=347).

Results. The ANP approach showed better results in most of the evaluated outcomes such as asthma quality documentation and self-management and the number of asthma symptoms was significantly lower. From a health economic perspective the results were encouraging with respect to ANP.

Conclusion. This alternative asthma strategy, ANP, improved asthma care in primary health care and resulted in economic advantages in the health care sector. However the result may only be generalized to other practices working with asthma nurses in the same way.

Place, publisher, year, edition, pages
2002. Vol. 16, no 1, 73-78 p.
National Category
Social Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28307DOI: 10.1046/j.1471-6712.2002.00054.xLocal ID: 13438OAI: oai:DiVA.org:liu-28307DiVA: diva2:249113
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Asthma nurse practice in primary health care: quality, costs and outcome
Open this publication in new window or tab >>Asthma nurse practice in primary health care: quality, costs and outcome
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The primary aim of the present work was to document and analyse whether it is beneficial to patients and to the health care sector to organise asthma care in primary health care is  the form of asthma nurse practices (ANPs). During the past decade ANPs have been established in primary health care in the county of Östergatland, Sweden. The prevalence of asthma is increasing in the industrialised world, and this focuses attention on the efficacy and quality of asthma care.

The methods, data collection and measurements that were used can be summarised as follows. The studies included: (i) a prospective intervention study (ANP concept) with pre- and post- test comparisons, objective measurements and patient questionnaires; (ii) further development of a patient questionnaire, validation of items by structured followHup telephone interviews using predetermined criteria; (iii) comparison of quality and cost in two different approaches to providing asthma care within primary health care, traditional care and care given at a primary health care centre with an ANP, by combining a retrospective review of documentation in patient records using a special form and a prospective approach using a patient questionnaire; (iv) semi-structured interviews with asthma patients to obtain their view of asthma care and clarify factors of importance for compliance with prescribed medication.

The evaluation demonstrated that on the group level, primary health care centres with ANPs resulted in better disease control, fewer asthma symptoms, and better patient experienced knowledge and self-management outcomes. The results also showed fewer emergency visits, better documentation of asthma management and better asthma quality outcomes. It was also found that health care costs were lower with the ANP than with traditional asthma care in primary health care. The patients expressed important aspects of the care as the need for security, including regular asthma check-ups, easy access to care, continuity in the care, competence ofthe health care staff, and information and knowledge about asthma. Increasing age, female gender, long duration of the disease, the attitude of the staff, and whether patients felt they had obtained information and education about asthma were all factors of importance for compliance with prescribed medication.

The main conclusion of the thesis was that the ANP concept seems to improve asthma care in primary health care and resulted in economic advantages for the health care sector.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 69 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 695
Keyword
asthma, asthma care, primary health care, family practice, nursing, quality, costs, consensus programs, guidelines
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27512 (URN)12168 (Local ID)91-7219-989-X (ISBN)12168 (Archive number)12168 (OAI)
Public defence
2001-11-09, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-11-09Bibliographically approved

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Lindberg, MalouAhlner, JohanJonsson, Dick

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General PracticeFaculty of Health SciencesClinical PharmacologyPulmonary MedicineCenter for Medical Technology AssessmentDepartment of Neuroscience and Locomotion
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