Development of an Integrated Care Model for Children with Asthma at Chiang Yuen Hospital, Mahasarakham Province.

Abstract

      This study aimed to develop an integrated care model for children with asthma at Chiang Yuen Hospital, Mahasarakham Province, and to compare asthma control and healthcare utilization before and after implementation of the model. This quasi experimental research consisted of three phases: situation and problem assessment; development of an integrated care model based on standard asthma-care guidance and empirical evidence; and implementation and evaluation. Participants were 126 children aged 2–15 years diagnosed with asthma and receiving care at Chiang Yuen Hospital. Eligible patients during the study period were included. Outcomes assessed before and after implementation were asthma control level, emergency department visits, and hospital admissions. Data were analyzed using frequency, percentage, mean, standard deviation, median, minimum–maximum, Stuart–Maxwell test, and Wilcoxon signed-rank test, with statistical significance set at .05.

      Results: The integrated care model comprised five components: a dedicated pediatric asthma clinic; education for children and caregivers; inhaler and spacer skill training; individualized Asthma Action Plans; and continuous follow-up via telephone or Line. Of 126 participants, 74 (58.73%) were male and 88 (69.84%) were aged 4–11 years. Before implementation, 56 (44.44%) had controlled asthma, 55 (43.65%) partially controlled asthma, and 15 (11.91%) uncontrolled asthma. After implementation, 70 (55.56%) were controlled and only 1 (0.79%) was uncontrolled. The distribution of asthma-control levels changed significantly (χ²(2)=18.15, p<0.001). Median emergency visits decreased from 2 (1–5) to 1 (0–2), and median hospital admissions decreased from 2 (1–3) to 0 (0–2); both differences were statistically significant (p<0.001).