The facilitator effect: results from a four-year follow-up of children with asthma

Mccowan, C. , Neville, R.G., Crombie, I.K., Clark, R.A. and Warner, F.C. (1997) The facilitator effect: results from a four-year follow-up of children with asthma. British Journal of General Practice, 47(416), pp. 156-160.

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BACKGROUND: A long-term evaluation of the process and outcomes of primary and secondary care is required to establish whether audit facilitators can improve the care of childhood asthma. AIM: To examine the long-term effect of an intervention by an audit facilitator on the management of children with asthma, and to investigate the implications for health service costs. METHOD: A 4-year follow up was conducted of an intervention and control group totalling 2557 children aged 1-15 years from 12 general practices in the Tayside region. Primary care consultations, prescriptions, hospital contacts and health service costs 1 year before and 3 years after a facilitator visited practices were recorded. The facilitator encouraged the diagnosis and treatment of childhood asthma in the intervention group. RESULTS: Favourable changes in consultation patterns, prescriptions and reduced hospital admissions seen during the intervention year did not persist in subsequent years. Two and three years after the facilitator visit the process and outcome of care was similar in both groups. The reduction in health service costs seen in the intervention group was equivalent to the cost of employing a facilitator. CONCLUSION: The effect of a facilitator lasts only for the period of intervention. Enthusiasts will say that improving patient care without increasing health service costs justifies the widespread deployment of facilitators. Others more interested in long-term outcomes may disagree.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mccowan, Professor Colin
Authors: Mccowan, C., Neville, R.G., Crombie, I.K., Clark, R.A., and Warner, F.C.
Subjects:R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:British Journal of General Practice
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