Efectividad de un programa de atención integral del paciente con asma sobre la frecuencia de exacerbaciones en una institución de cuarto nivel de la ciudad de Bogotá (Colombia)

Abstract

Asthma is a pulmonary disease of multifactorial cause with big burden to all health systems around the world which led to the creation of integral attention programs as an strategy aimed to improving the standards of attention especially in developing countries, reaching a decrease in health expenditures and a improved treatment for patients based on guidelines. This study aims to evaluate the effectivity of the Fundación neumológica's ASMAIRE program to reduce the severe exacerbations during the first year of follow up through a historic cohort of those patient included in the program with a before and after cohort, where every subjects acts as its own control. We did a comparation of the different variables before and after the entry of every patient to the program and one year later. Incidence densities and uni and multivariate Poisson regression models were used. 715 patients were analyzed, finding that after admission to ASMAIRE there was a decrease in EPS consultations (RR 0.44 IC95%: 0.32, 0.61 p = 0.0001), emergencies (RR 0.83 IC95% 0.71, 0.98 p = 0.029) as well as the need for hospitalizations (RR 0.31 IC95%: 0.23, 0.42 p = 0.0001) and admission to the ICU (RR 0.07 IC 95%: 0.03; 0.14 p = 0.0001). In conclusion the admission to the ASMAIRE program, managed to reduce the presence of exacerbations that required consulting EPS or emergencies as well as the need for hospitalizations and admission to the ICU in the first year of follow-up.