Journal Article

6482 Do integrated paediatric asthma interventions in one ICS reach those most in need in the community that they serve?

Watson, Mando, Richards, Emily, Hargreaves, Dougal

2024

Overview

ObjectivesAsthma is the most common non-communicable disease in children,1 and the UK has among the highest childhood asthma death rates in Europe.2 Integrated paediatric asthma care in the North West London ICS aims to improve clinical care for these children through MDT case-based discussions and Group Consultations. These bring hospital specialists to GP practices to review individual cases and share knowledge.It is important to evaluate whether integrated models of care are reaching patient groups most in need.3 We compared patient demographics for the GP practices that had taken part in these integrated care interventions with the related local authority. We used three measures as a proxy for need: the Indices of Multiple Deprivation (IMD) score, the hospital admission rate for asthma in patients <19 years old, and the proportion of patients <18 years old living in highly polluted areas.MethodsAsthma interventions taking place between November 2021 and July 2023 were analysed. 40 GP practices were involved in these interventions. Data relating to these practices and local authorities were obtained from fingertips.phe and the ICS’s linked datasets.For each of the three markers (deprivation, hospital admissions, and air pollution), we used t-tests in Excel to compare the GP practice data with data for the surrounding area.ResultsThe mean IMD score for the patients at the GP practices was 24.7 compared with 21.4 for the surrounding local authority, showing they are significantly more deprived than the surrounding area (p=0.003).Hospital admission data for asthma was available for 19 out of 40 GP practices. There was no statistically significant difference between admission rates for intervention GP practices and the Local Authority as a whole (227 versus 168 admissions per 100,000, p=0.118).Air pollution data was available for 38 out of the 40 practices. There was no significant difference between the proportion of patients living in high pollution areas at the intervention GP practices compared with the Local Authority as whole (1.71% vs 2.76% respectively, p=0.131).ConclusionOur study shows that an integrated model of paediatric asthma care can reach the more deprived patients in the areas they are targeted. These patients have levels of hospital admissions for asthma and live in areas with air pollution comparable to the average for the overall area.ReferencesH Zar, T Ferkol, The Global Burden of Respiratory Disease- Impact on Child Health, 2014R Shah, et al. International comparisons of health and wellbeing in adolescence and early adulthood, 2019.S Baxter, et al. The effects of integrated care: a systematic review of UK and international evidence, 2018.

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD
• Subject: Air pollution / Asthma / British Paediatric Respiratory Society / Children / Communicable Diseases / Hospitals / Integrated delivery systems / Local government / Patient admissions / Patients / Pediatrics / Pollution / Respiratory diseases / Statistical analysis