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Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO.
Arch Intern Med. 1997 Jun 09; 157(11):1201-8.AI

Abstract

OBJECTIVE

To examine the differences in medical management and quality of life between patients with asthma who receive their primary asthma care from allergists and those who receive their care from generalists in a large health maintenance organization (HMO).

METHODS

We conducted a cross-sectional study of patients with asthma in a large HMO (Kaiser Permanente, Northwest Region, Portland, Ore). Participants were 392 individuals aged 15 through 55 years with physician-diagnosed asthma, taking antiasthma medications, reporting current asthma symptoms, and receiving asthma care from an allergist or from a generalist. Primary outcomes include characteristics of asthma, health care utilization, and quality of life.

RESULTS

Patients cared for by allergists tended to have more severe asthma than those cared for by generalists (P < .01). The allergists' patients tended to be older (38.6 +/- 9.6 years vs 35.7 +/- 12.6 years, P < .01), more atopic (91% vs 78%, P < .01), and more likely to report perennial (rather than seasonal) asthma (26% vs 36%, P < .04) than the generalists' patients. Patients receiving their primary asthma care from an allergist were considerably more likely than generalists' patients to report using inhaled anti-inflammatory agents (P < .01), oral steroids (P < .01), and regular (daily) breathing medications to control their asthma (P < .01). Allergists' patients were more likely to have asthma exacerbations treated in a clinic setting rather than an emergency department (P < .01). Furthermore, allergists' patients reported significantly improved quality of life as measured by several dimensions of the SF-36 scale (physical functioning, role emotional, bodily pain, and general health; P < .05).

CONCLUSIONS

These findings suggest that specialist care of asthma is of benefit for patients with asthma in a large HMO. Specifically, the allergists' patients conformed more closely to national asthma management guidelines and reported better quality of life than did the generalists' patients.

Authors+Show Affiliations

Kaiser Permanente Center for Health Research, Portland, OR, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9183231

Citation

Vollmer, W M., et al. "Specialty Differences in the Management of Asthma. a Cross-sectional Assessment of Allergists' Patients and Generalists' Patients in a Large HMO." Archives of Internal Medicine, vol. 157, no. 11, 1997, pp. 1201-8.
Vollmer WM, O'Hollaren M, Ettinger KM, et al. Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO. Arch Intern Med. 1997;157(11):1201-8.
Vollmer, W. M., O'Hollaren, M., Ettinger, K. M., Stibolt, T., Wilkins, J., Buist, A. S., Linton, K. L., & Osborne, M. L. (1997). Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO. Archives of Internal Medicine, 157(11), 1201-8.
Vollmer WM, et al. Specialty Differences in the Management of Asthma. a Cross-sectional Assessment of Allergists' Patients and Generalists' Patients in a Large HMO. Arch Intern Med. 1997 Jun 9;157(11):1201-8. PubMed PMID: 9183231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO. AU - Vollmer,W M, AU - O'Hollaren,M, AU - Ettinger,K M, AU - Stibolt,T, AU - Wilkins,J, AU - Buist,A S, AU - Linton,K L, AU - Osborne,M L, PY - 1997/6/9/pubmed PY - 1997/6/9/medline PY - 1997/6/9/entrez SP - 1201 EP - 8 JF - Archives of internal medicine JO - Arch Intern Med VL - 157 IS - 11 N2 - OBJECTIVE: To examine the differences in medical management and quality of life between patients with asthma who receive their primary asthma care from allergists and those who receive their care from generalists in a large health maintenance organization (HMO). METHODS: We conducted a cross-sectional study of patients with asthma in a large HMO (Kaiser Permanente, Northwest Region, Portland, Ore). Participants were 392 individuals aged 15 through 55 years with physician-diagnosed asthma, taking antiasthma medications, reporting current asthma symptoms, and receiving asthma care from an allergist or from a generalist. Primary outcomes include characteristics of asthma, health care utilization, and quality of life. RESULTS: Patients cared for by allergists tended to have more severe asthma than those cared for by generalists (P < .01). The allergists' patients tended to be older (38.6 +/- 9.6 years vs 35.7 +/- 12.6 years, P < .01), more atopic (91% vs 78%, P < .01), and more likely to report perennial (rather than seasonal) asthma (26% vs 36%, P < .04) than the generalists' patients. Patients receiving their primary asthma care from an allergist were considerably more likely than generalists' patients to report using inhaled anti-inflammatory agents (P < .01), oral steroids (P < .01), and regular (daily) breathing medications to control their asthma (P < .01). Allergists' patients were more likely to have asthma exacerbations treated in a clinic setting rather than an emergency department (P < .01). Furthermore, allergists' patients reported significantly improved quality of life as measured by several dimensions of the SF-36 scale (physical functioning, role emotional, bodily pain, and general health; P < .05). CONCLUSIONS: These findings suggest that specialist care of asthma is of benefit for patients with asthma in a large HMO. Specifically, the allergists' patients conformed more closely to national asthma management guidelines and reported better quality of life than did the generalists' patients. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/9183231/Specialty_differences_in_the_management_of_asthma__A_cross_sectional_assessment_of_allergists'_patients_and_generalists'_patients_in_a_large_HMO_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/157/pg/1201 DB - PRIME DP - Unbound Medicine ER -