Priority Area: Healthy Environment - Asthma
The Burden of Asthma
Asthma is a chronic disease of the lungs and is the most common chronic disease in children. Over the past 25 years, asthma has emerged as a significant health problem in the United States. In 2007, approximately 18.6 million (8.2%) adults and 6.7 million (9.1%) children indicated that they currently had asthma.1,2 in 2006, there were 1.7 million asthma emergency department (ED) visits nationally.3 Asthma hospitalization and death rates in the United States decreased from 2000 to 2004.4,5 However, in 2006, there were still 444,000 asthma hospitalizations nationally for a rate of 14.9 per 10,000 and 3,600 deaths due to asthma in the United States for a rate of 1.2 per 100,000.6,7 In 2008, an estimated 14.4 million school days and 14.2 million work days were missed due to asthma.8 The projected 2010 costs associated with asthma are $20.7 billion, including $15.6 billion in direct health care costs and $5.1 billion for indirect costs such as lost productivity.9
In 2008, an estimated 1.3 million adults currently had asthma. Current asthma prevalence among adults increased from 6.3% in 1999 to 8.7% in 2008. The current asthma prevalence among adults in New York State (NYS) has been higher than the national average since 2002. For 2006-2008, the annual current asthma prevalence for children (0-17 years) was 11%, with an estimated 491,000 children with current asthma.10 There were more than 166,000 ED visits and over 39,000 hospitalizations per year due to asthma for the time period 2006 to 2008. NYS asthma ED visits and hospitalization rates were higher than the national rates for all age groups and exceeded the Healthy People 2010 objectives. For 2006-2008, an average of 238 deaths due to asthma occurred per year in NYS, which is an age-adjusted asthma mortality rate of 11.5 per one million residents. The total cost of asthma hospitalizations in NYS in 2007 was approximately $535 million.10
Asthma is a burden on patients, families, and communities, with significant public health and financial consequences. Asthma is the leading cause of school absenteeism and results in many lost hours of sleep and disruption of activities for the individual with asthma, as well as for family members. Parents frequently miss days from work as a result of their child's asthma.
Although there is no cure for asthma, much more is known about it today than was known 20 years ago. A public health approach to prevent or control asthma involves educating the public and health professionals about prevention and treatment, improving access to quality asthma care and changing lifestyles to eliminate environmental factors that trigger asthma. NYSDOH is actively working with health care providers, community coalitions, schools, families and many others to reduce or control asthma so people with asthma can live a full and active life.
- Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data. Available from: http://www.cdc.gov/asthma/brfss/07/current/tablec1.htm [Last accessed: April 23, 2013].
- Centers for Disease Control and Prevention. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2007 (Table 1). Available from: http://www.cdc.gov/nchs/data/series/sr_10/sr10_239.pdf [Last accessed: April 23, 2013].
- Schappert SM, Rechtsteiner EA. National Center for Health Statistics. Ambulatory Medical Care Utilization Estimates for 2006. National Health Statistics Reports; No 8. August 6, 2008, Hyattsville, MD: National Center for Health Statistics. Available from: http://www.cdc.gov/nchs/data/nhsr/nhsr008.pdf [Last accessed: April 23, 2013].
- Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, Scalia MR, Akinbami LJ.National Surveillance for Asthma – United States, 1980–2004. Morbidity & Mortality Weekly Report, 2007. 56(SS08): p. 1-14; 18-54. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5608a1.htm [Last accessed: April 23, 2013].
- Akinbami LJ.The State of Childhood Asthma, United States, 1980–2005. Advance data from vital and health statistics; no 381, Hyattsville, MD: National Center for Health Statistics. 2006. Available from: http://www.cdc.gov/nchs/data/ad/ad381.pdf [Last accessed: April 23, 2013].
- DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A. 2006 National Hospital Discharge Survey (Table 2, 3). National health statistics reports; no 5. Hyattsville, MD: National Center for Health Statistics. 2008. Available from: http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf [Last accessed: April 23, 2013].
- Heron M, Hoyert DL, Murphy SL, Xu J, Kochanek KD, Tejada-Vera B.Deaths: Final Data for 2006. National Vital Statistics Reports; v 57. Hyattsville, MD: National Center for Health Statistics. 2009. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf [Last accessed: April 23, 2013].
- American Lung Association, Trends in Asthma Morbidity and Mortality, February 2010. Available from: http://www.lung.org/finding-cures/our-research/trend-reports/asthma-trend-report.pdf [Last accessed: April 23, 2013].
- National Heart, Lung and Blood Institute Chart Book on Cardiovascular, Lung and Blood Diseases, U.S. Department of Health and Human Services, National Institute of Health, 2009. Available from: http://www.nhlbi.nih.gov/resources/docs/2009_ChartBook.pdf [Last accessed: April 23, 2013].
- Public Health Information Group, New York State Department of Health.New York State Asthma Surveillance Summary Report - October 2009. Available from: http://www.health.ny.gov/statistics/ny_asthma/pdf/2009_asthma_surveillance_summary_report.pdf [Last accessed: April 23, 2013].
Asthma is an ambulatory care-sensitive condition, which is defined as a medical problem that is potentially preventable and can be treated outside of the hospital. With appropriate asthma care management and avoidance of environmental triggers, most people with asthma should not need to be hospitalized. Hospitalizations for asthma may indicate problems or deficiencies in ambulatory care. Therefore, asthma related hospitalizations (per 10,000 population) are tracked for the total population as well as for children 0-17 years of age.
By the year 2013, reduce asthma related hospitalizations in New York so that:
- The age-adjusted asthma hospitalization rate is no more than 16.7 per 10,000 population (Baseline: 22.2 per 10,000, SPARCS, 2003-2005)**
- The asthma hospitalization rate among children (ages 0-17) is no more than 17.3 per 10,000 population (Baseline: 34.1 per 10,000, SPARCS, 2003-2005)*
* Healthy People 2010 Objective
**Healthy People 2010 objective not established for total population – 25% reduction from 2003-05 baseline.
Indicators for Tracking Public Health Priority Areas
Each community's progress towards reaching these Prevention Agenda Objectives will be tracked so members can see how close each community is to meeting the objectives.
- Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data. Available from: http://www.cdc.gov/asthma/brfss/07/current/tablec1.htm [Last accessed: June 17, 2009].
- State and County Indicators For Tracking Public Health Priority Areas
Data and Statistics Information on Asthma in New York State
- ZIP code level data by county are available on the NYSDOH asthma website to assist regional asthma coalitions and others in their asthma prevention and control efforts.
- New York State Asthma Surveillance Summary Report - October 2009 (PDF, 2.35MB, 202pg.) (Posted 3/11/2010)
- New York State Asthma Surveillance Summary Report - October 2007 (PDF, 2.3MB, 170pg.)
- New York State Asthma Surveillance Summary Report - October 2005 (PDF, 4.1MB, 88pg.)
- National Asthma Survey - New York State Summary Report (PDF, 1.4MB, 90pg.)
- New York City - Asthma Facts: This publication uses hospital discharge and mortality data to describe the problem of asthma in New York City. (PDF, 740KB, 50pg.)
Statistics on Asthma
Lifetime and current asthma prevalence data by selected sociodemographic groups are presented for the United States and NYS. These estimates are produced from the responses to two asthma questions on the BRFSS Core Questionnaire.
Emergency department (ED) visit data from the Statewide Planning and Research Cooperative System (SPARCS) were used to calculate county-specific and ZIP code level asthma ED visit rates organized by regions within NYS.
- Asthma Emergency Department Visits in New York State by Region and County
- Asthma Emergency Department Visits in New York State by County and ZIP Code
Hospital discharge data from the Statewide Planning and Research Cooperative System (SPARCS) were used to calculate county-specific and ZIP code level asthma hospital discharge rates organized by regions within NYS.
- Asthma Hospital Discharge Data in New York State by Region and County
- Asthma Hospital Discharge Data in New York State by County and ZIP Code
Data on county-specific asthma death rates, both crude and adjusted, are available by region within NYS. Data were obtained from death certificates.
Quality Assurance Reporting Requirements (QARR) – Online Report of Managed Care Plan Performance in NYS
Interactive reports on the performance of health plans are available through the NYSDOH website. These QARR reports are designed to help consumers choose health plans that meet their needs and the needs of their families. The reports provide easy-to-read information on health plan performance including provision of primary and preventive health care. Data are presented for commercial and government-sponsored managed care plans.
Prevention Quality Indicators
The Prevention Quality Indicator (PQI) website is the first free, publicly accessible tool in NYS to identify hospitalization rates by ZIP code for ambulatory care sensitive conditions. Information is also provided on health disparities by displaying data for patients' race and ethnicity. The QARR report measures the effectiveness of managed care plans in treating asthma. The most recent version of this report identifies how Medicaid managed care plans and commercial insurance plans perform on specific health measures, including asthma management. The report is one of the most comprehensive summaries for managed care in the nation (see NYS Managed Care Plan Performance Reports (QARR)).
New York State Asthma Control Program
Overview of New York State Department of Health Asthma Plan and Asthma Initiatives
NYS is committed to improving the quality of life for those with asthma and their families. The goals of the New York State Asthma Plan (NYSAP) for 2006-2011 are that:
- Seamless, evidence-based, patient/family centered asthma care exists for all New Yorkers with asthma.
- Disparities in asthma diagnosis, treatment and outcomes are eliminated.
- “Asthma friendly” communities exist in New York.
- Policymakers, health care providers and consumers have an increased understanding of asthma, and treat and manage asthma effectively.
- A statewide public/private collaboration exists to shape, implement and monitor New York States Asthma Plan which aims to improve asthma outcomes in New York.
Asthma Partnership of New York (APNY)
To achieve the goals of NYSAP, the Asthma Partnership of New York (APNY), a public and private collaboration, mobilized a statewide coalition of partners to plan, implement and evaluate population-based and patient-centered strategies to improve asthma-associated outcomes. The APNY connects more than 1,000 organizations across the state, including the New York City Department of Health and Mental Hygiene, the New York City Asthma Partnership, the New York City Department of Education, the Business Council of the State of New York, medical societies, regional asthma coalitions, professional societies and associations, health plans, local health departments, hospitals, clinics, home intervention programs, and community organizations, to implement key asthma initiatives.
The numerous initiatives underway to meet the NYSAP goals are organized into four focus areas:
- Surveillance and program evaluation
- Health care
- Community-based initiatives
- Environmental and occupational health
Asthma Program Initiatives in New York State
Surveillance and Program Evaluation Team Activities
- Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey
- The Asthma Call-Back Survey (ACB) is a survey that is linked to the BRFSS.: The ACB survey was first administered in NYS in 2006 and annually thereafter. Respondents to the NYS BRFSS survey who reported having lifetime asthma themselves or having a child with lifetime asthma were asked to participate in the ACB, within two weeks of the original interview, to provide more information about their asthma or that of their child. Information was then obtained for only one adult or one child per household. The ACB collects in-depth information about asthma prevalence, asthma symptoms and episodes or attacks, asthma management, healthcare utilization, asthma medications, work/school related asthma, comorbidity, and the presence of environmental triggers and practices that promote or reduce common triggers. These data are reported in specific surveillance publications and presentations.
- Information on Asthma in New York State
- The Asthma Surveillance and Evaluation Team analyzes asthma measures annually (e.g. asthma prevalence, hospitalizations, emergency department (ED) visits, asthma severity and control, asthma self-management, and asthma deaths) using multiple datasets (e.g., the Behavioral Risk Factor Surveillance System (BRFSS) data, the Statewide Planning and Research Cooperative System (SPARCS) outpatient and in-patient data, the BRFSS Asthma Callback Survey (ACB) data, and Vital Statistics data). Analytic results have been disseminated via the NYSDOH public website: “Information on Asthma in New York State(see www.health.ny.gov/statistics/ny_asthma/). From this site, asthma partners and public audience can access approximately 3,000 web pages on asthma prevalence, ED visits, hospitalizations, and mortality at the State, regional, county and ZIP code levels.
- New York State Asthma Surveillance Summary Report
- The Asthma Surveillance and Evaluation Team develops the New York State Asthma Surveillance Summary Report on a regular basis. These reports present data on asthma prevalence, hospitalizations, ED visits, asthma related services and costs, work-related asthma, asthma among Medicaid population, asthma and the environment, and asthma deaths. To date, three New York State Asthma Surveillance Summary Reports (2005, 2007 and 2009) have been developed and disseminated to asthma partners across New York State, other states and CDC. These reports are published on the Information on Asthma in New York State on the DOH web site.
- BRFSS Asthma Call-Back Survey Report
- The Asthma Surveillance and Evaluation Team has been developing this report using the NYS BRFSS and ACB survey data for the years 2006 through 2008. It includes the following topics and indicators: Healthy People 2010 asthma-related objectives; asthma incidence; asthma prevalence; asthma control and severity; asthma episodes/attacks; asthma medication use; health care utilization (asthma routine visits, asthma urgent visits, and asthma ED visits); health care coverage (having insurance coverage, continuation of health insurance); health care cost barriers; quality of life - asthma’s impact on usual activities; missed school and work days due to asthma; knowledge of asthma management (taught by a doctor or other health care professional to recognize early asthma symptoms, what to do during an asthma episode or attack, and receipt of an asthma management plan); school-related asthma; work-related asthma; the indoor home environment; and co-morbidities. These topics and indicators are often presented for children (aged 0–17 years), adults (aged 18 years and older), and by race and ethnicity for the total asthma population. This report can be used to assist public health programs, policy makers, and healthcare providers in their efforts to determine the scope of the asthma problem, understand important factors that affect asthma, identify opportunities for improvement and design solutions to reduce the burden of asthma. This report is scheduled to be published on the "Information on Asthma in New York State” DOH web site during Spring 2011.
- Asthma Evaluation Projects
- The Asthma Surveillance and Evaluation Team is primarily responsible for leading and coordinating evaluation efforts within the New York State Asthma Control Program. The Asthma Surveillance and Evaluation Unit has helped to design and conduct the evaluations of various programs and projects e.g., the evaluation of the NYS Asthma Regional Asthma Coalitions; the Open Airways Program; the NYS School-based Health Center (SBHC) Asthma Learning Collaborative; NYS SBHC Asthma and Influenza Vaccination Campaign; and the NYS SBHC Quality Improvement Collaborative. Current efforts have been focused on a major deliverable from the CDC Asthma Grant: the development of the Strategic Evaluation Plan for the New York State Asthma Control Program. The Strategic Evaluation Plan includes the evaluation of three core components of the grant: Asthma Partnership of New York, asthma surveillance system, and asthma interventions; and the expanded component of the grant. This plan will be implemented during 2010-2014 .
Health Care Initiatives
- Child Health Plus
- Child Health Plus provides coverage to children under the age of 19 residing in NYS with limited family incomes and no health insurance (see www.health.ny.gov/health_care/child_health_plus/).
- Family Health Plus
- Family Health Plus is available to adults between the ages of 19 and 64 years who are residents of NYS and are either U.S. citizens or fall under one of many immigration categories, who do not have health insurance and have incomes too high to qualify for Medicaid (see www.health.ny.gov/health_care/family_health_plus/).
- Healthy New York
- Healthy New York is a program for uninsured employed individuals and students who are no longer insured under their families’ coverage.
- Medicaid recipients have access to a benefit package covering services necessary to manage asthma including, but not limited to, medications and prescription drugs, spacers, peak flow meters, nebulizers, pulmonary diagnostic tests, doctor visits and hospital care (See Medicaid in New York State).
- NYS Asthma Guideline
- Based on the Clinical Application of the National Asthma Education and Prevention Program (NAEPP) Expert Panel Report 3 (EPR3 Guidelines for the Diagnosis & Management of Asthma , a NYS expert panel produced a decision support tool that established a common standard of care for providers and health plans. The tool, Clinical Guideline for the Diagnosis, Evaluation, and Management of Adults and Children with Asthma, has been endorsed by professional societies, associations and health plans and distributed to over 20,000 physicians in NYS (see www.health.ny.gov/diseases/asthma/pdf/asthma_guidelines.pdf).
- Asthma in Primary Care Practice
- NYSDOH supported Dr. Mamta Reddy, Chief of Allergy and Immunology, Bronx-Lebanon Hospital Center and Director of the South Bronx Asthma Partnership, to develop a case study-based DVD, entitled Clinical Application of the National Asthma Education and Prevention Program (NAEPP) Expert Panel Report3: Guidelines for the Diagnosis & Management of Asthma. It is based on the NAEPP EPR3 and promotes the translation of the asthma guidelines into primary care practice. The content of the DVD is acceptable for three CME credits by the American Academy of Family Physicians. This DVD is available until May 31, 2011 for distance learning opportunities for health care providers (see http://jeny.ipro.org/files/Asthma/).
- Asthma Model Benefit Package
- This assessment of public health insurance (Medicaid, Family Health Plus and Child Health Plus) benefit coverage for asthma care describes how the benefit packages differ and how they could be better aligned to support good asthma care.
- Asthma Self Management Education
- A new Social Services Law (§ 365A 2 (r), effective January 1, 2009, allows NYS Medicaid to cover asthma self-management education for Medicaid beneficiaries diagnosed with asthma when these services are ordered by a physician, registered physician's assistant, registered nurse practitioner, or a licensed midwife. Self-management education must be provided by a New York State licensed, registered, or certified health care professional, who is also certified as an educator by the National Asthma Educator Certification Board. Certified Asthma Educators (AECs) are required to enroll in the NYS State Medicaid program as non-billing providers and must be employed by or contract with an appropriate billing provider. For more information about AEC enrollment forms and instructions see www.emedny.org/ info/ProviderEnrollment/. For detailed information regarding asthma education services, refer to the October 2008 Medicaid Update (see www.health.ny.gov/health_care/medicaid/program/update/2008/2008-10.htm#dia).
- Asthma Website
- The NYSDOH maintains an asthma website (see www.health.ny.gov/diseases/asthma/) for all New Yorkers to obtain information on asthma surveillance, interventions, care and educational materials.
- Regional Asthma Coalitions
- Eleven regional asthma coalitions work to mobilize local resources to reduce morbidity and mortality through advocacy, education, partnerships and interventions. These coalitions are an effective strategy for addressing asthma regionally.
- NYS Asthma Outcomes Learning Network
- The NYSDOH Asthma Control Program has partnered with the National Initiative for Children’s Health Care Quality and the 11 regional asthma coalitions to improve the quality of asthma care among children in New York. Each year, 11 asthma improvement teams, representing large health care and community systems, receive training in quality improvement practices, then apply these methods locally and share key learning principles through this Network. More than 50 teams and over 260 health care leaders have been trained.
- School-Based Health Centers (SBHCs)
- There are over 200 SBHCs in NYS that play a critical role in providing primary and preventive care to children, including quality asthma care and management (see www.health.ny.gov/facilities/school_based_health_centers/).
- School-Based Health Center Quality Improvement Collaborative
- A Quality Improvement Collaborative to improve asthma care was conducted in 25 school-based health centers. This initiative produces changes in the system of care within the centers to improved outcomes for all children with asthma, especially among children with poorly-controlled asthma. This 18-month initiative used the Breakthrough Series methodology developed by the Institute for Healthcare Improvement.
- Asthma and Influenza
- The NYSDOH launched an Asthma and Influenza Education Campaign to raise awareness about the importance of receiving influenza vaccinations, especially for those with asthma. Educational materials for providers, people with asthma and their families, and the community were developed and are available on the public web site.
- Winning with Asthma – Coaches Clipboard Program
- This 30-minute online educational program was created to train coaches about asthma, how this condition affects an athlete’s ability to compete, and how a coach can help athletes control their asthma while playing their very best (www.health.ny.gov/diseases/asthma/athletic_field.htm). The Asthma Control Program is promoting this program among coaches of youth sports and activities, athletic directors, physical education teachers and school nurses.
- Treatment of Students with Asthma
- NYS Legislation passed in 1998 (Education Law 16, Article 19, Section 916) requires schools and Boards of Cooperative Educational Services (BOCES) to allow students who have been diagnosed by a physician with a severe asthmatic condition to carry and use prescribed inhalers during the school day.
Environmental and Occupational Health Initiatives
- Healthy Neighborhoods Program
- The Healthy Neighborhoods Program provides in-home assessments and interventions for asthma, tobacco cessation, indoor air quality, lead and fire safety in selected communities throughout the state. For residents with asthma, interventions may include asthma trigger education; dust, mold, and pest control measures; distribution of pillow and mattress covers; and smoking cessation education.
- Healthy Home Environments for New Yorkers with Asthma (HHENYA)
- In Western NY, the NYSDOH collaborated with four managed care plans and the Erie County Healthy Neighborhoods Program to develop and implement a pilot program to integrate management of environmental triggers into routine asthma care. Participating health plans identify and refer eligible patients to the HHENYA program, which provides each patient with an in-home assessment, education, supplies and referrals to address environmental and other problems identified during the home visit.
- School AIR Collaborative: Addressing Indoor Air Quality (IAQ) Roadblocks
- Many resources are available to help schools identify and fix IAQ problems that may affect students and staff with asthma, but these resources are not always used. Findings suggest that even when policies or practices do exist, they are not always enforced or fully implemented. An interdisciplinary team within the NYS Asthma Control Program worked with 10 schools in the Capital District to learn more about potential barriers to implementation of IAQ programs and to identify strategies for overcoming those barriers.
- School Environmental Assessment Project
- The purpose of this project was to better understand the problem of asthma in the school setting and to examine the influence of school environments on childhood asthma. A summary report, Asthma and the School Environment in NYS, was disseminated to school districts and stakeholders to share project findings and statewide information that may help schools to create asthma-friendly learning environments.
- Occupational Lung Disease Toolkit
- Through this initiative, a health care provider toolkit for improving the recognition and reporting of occupational lung diseases, including work-related asthma, was developed and distributed. A brochure, Is Your Asthma Work-Related?, was also developed to help workers identify whether they have work-related asthma.
- Air Quality Health Advisories
- The Commissioners of the NYSDOH and the NYS Department of Environmental Conservation (NYSDEC) have agreed to issue a joint press release when forecasted ground-level ozone or fine particle ambient (or air pollution) concentrations are of concern, especially for people with health conditions such as asthma. Local health units and media outlets are notified of advisories in their regions and are directed to the NYSDOH and NYSDEC websites which provide advice on ways to reduce exposure and steps that citizens can take to reduce air pollution.
- Smoking and Idling Trucks Enforcement
- NYSDEC addresses urban outdoor air quality for mobile sources by targeted enforcement of smoking restrictions or idling trucks in violation of the State air quality regulations. NYSDEC law enforcement officers issue tickets to diesel trucks that fail to comply with State standards on emissions and to trucks or buses idling illegally. The areas of enforcement are those with high-traffic volume, many of which are in environmental justice communities that suffer from high asthma.
- Environmental Education and Outreach Project
- A statewide asthma educational needs assessment was conducted to determine key messages and best practice educational materials regarding the environmental and occupational triggers of asthma. The assessment found persistent problems in communication between providers and their patients. As a result, a series of brochures was developed to enhance communication between patients and providers. The Have Asthma? and Trigger Tracker tools focus on helping people with asthma identify their asthma triggers and offer practical ideas for reducing exposure to indoor and outdoor triggers. These tools were designed to meet a range of literacy skills and are available in English and Spanish.
- Environmental Public Health Tracking (EPHT)
- EPHT is the ongoing collection, integration, analysis and interpretation of data on environmental hazards and potential health effects related to exposures to these hazards. The NYSDOH received a five-year grant from the Centers for Disease Control and Prevention (CDC) in 2006 to develop an EPHT network that is tracking a core set of nationally-consistent data relating to issues such as asthma, ambient air concentrations of ozone and fine particles. The NYS EPHT program collaborates with the NYSDOH Asthma Control Program, the NYSDEC, CDC and the U.S. Environmental Protection Agency to disseminate coherent public health messages based on the analyses of these data.
- Environmental Health Research
- The NYSDOH supports continuing analysis and exploration to determine the key environmental factors contributing to asthma development and morbidity. The NYSDOH builds upon information from environmental asthma research to develop more effective public health programs aimed at reducing or eliminating exposure.
Strategies – The Evidence Base for Effective Interventions
- Clinical Guideline for the Diagnosis, Evaluation, and Management of Adults and Children with Asthma (PDF, 240KB, 16pg.)
- National Heart, Lung, and Blood Institute: Guidelines for the Diagnosis and Management of Asthma (EPR-3) - 2007
- Key Clinical Activities for Quality Asthma Care: Recommendations of the National Asthma Education and Prevention Program. MMWR Recommendations and Reports 2003 March 28;52(No. RR-6);1-8.(PDF, 247KB, 12pg.)
- Working Group Report on Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment - Update 2004 (NIH)
- Recommendations for the Prevention and Control of Influenza. MMWR Recommendations and Reports 2008 August 8;57(RR-7):1-60.
Best Practices for Comprehensive Asthma Control Programs (2007) - The Centers for Disease Control and Prevention (CDC)
Control of asthma requires appropriate diagnosis, effective use of medications, knowledge and understanding of the causes and consequences of the disease, and modifications of environmental exposures and behaviors that may negatively impact the disease. In addition to what occurs in clinician’s office, a number of interventions have been demonstrated to improve asthma control and are implemented in community settings with groups of people who have asthma.
The CDC website describes potentially-effective interventions for asthma, including a methodology to identify interventions, results, lessons learned, information on the interventions, a bibliography of reviewed literature, and case studies of several interventions.
Reports and Resources
- Asthma Care Quality Improvement Workbook and Resource Guide
- The Asthma Care Quality Improvement Workbook and Resource Guide helps state leaders assess the quality of their state's asthma care and create quality improvement strategies. The Resource Guide provides background information on why states should consider asthma as a priority for state action, presents analysis of state and national data and measures of asthma quality of care, and gives guidance for developing a state quality improvement plan. A list of over 100 separate national, state, and local efforts to improve asthma care quality is included. The interactive workbook presents review exercises for state leaders on the key skills and lessons from the Resource Guide.
Return on Investment
- Goetzel R, Ozminkowski R, Villagra V, et al. Return on investment in disease management: a review. Health Care Financing Review 2005;(26)4:1-19.
- The results of 44 studies investigating financial impact and return on investment from disease management programs for asthma, congestive heart failure, diabetes, depression, and multiple illnesses were examined. A systematic review of return on investment for asthma suggests that $2.72 was saved for every dollar spent on asthma disease management programs, on average, across six studies that provided sufficient data to calculate per-participant cost savings relative to program costs. The average program cost was $269 and the average cost saving was $729 per participant.
- Asthma Return on Investment Calculator
- The Asthma Return on Investment (ROI) Calculator, on the Agency for Healthcare Research and Quality (AHRQ) website, helps estimate the financial benefits of asthma quality improvement programs in a state. The calculator combines information from published studies with real-world data about patients to estimate the net impact of an asthma care quality improvement program. It includes information on medical utilization, cost of asthma and asthma prevalence, with a particular focus on programs that highlight patient and provider education on how to better manage the disease.
The NYS Asthma Control Program works collaboratively with local, state and national partners to reduce the burden of asthma in New York.
- Asthma Partnership of New York
- Regional Coalitions
- New York City Childhood Asthma Initiative
- New York City Childhood Asthma Partnership
- American Lung Association
- Centers for Disease Control and Prevention, Air Pollution and Respiratory Health Branch
- U.S. Environmental Protection Agency (EPA)
- The EPA is committed to educating all Americans about asthma so that everyone knows what asthma is, how the environment can affect asthma patients and how to manage environmental asthma triggers. Learn more about factors found in the indoor and outdoor environment that can cause, trigger, or exacerbate asthma symptoms and what to do to reduce their impact.
- National Initiative for Children's Healthcare Quality
- The National Initiative for Children's Healthcare Quality (NICHQ) is an education and research organization dedicated solely to improving the quality of health care provided to children. Founded in 1999, NICHQ's mission is to eliminate the gap between what is and what can be in health care for all children. NICHQ connects organizations and individuals who care about children with those who are experts in improvement. NICHQ's core services include educational programs, including Learning Collaboratives, regional improvement partnerships, and a quality performance data system.
- Improving Chronic Illness Care
- Improving Chronic Illness Care is a national program of The Robert Wood Johnson Foundation, based at the MacColl Institute for Healthcare Innovation, within the Group Health Cooperative of Seattle. The program seeks to improve the care of the chronically ill through three main program components: Improvement Collaboratives, Targeted Research Grants Program, and a Dissemination Project. The Chronic Care Model is the centerpiece of the Improving Chronic Illness Care program.
More InformationNYSDOH Asthma Control Program
150 Broadway, Suite 350, Menands, NY 12204
NYSDOH Asthma Control Program