Report on Services and Outcomes

During patient visits, Mobile C.A.R.E. staff members collect information that is periodically evaluated to determine the demographics of the children served by Mobile C.A.R.E., the severity of asthma symptoms in the patient population, and the outcomes of Mobile C.A.R.E. services.

The remainder of this page provides a summary of some of our recent findings. We're proud to report — Mobile C.A.R.E. does make a difference!

Demographics and Diagnostics

The Mobile C.A.R.E. Foundation has accomplished much since the Asthma Vans began their service in November of 1999.

Mobile C.A.R.E. Demographics and Diagnostics 11/01/99 to 12/31/06
Surveyed for Asthma:	About 45,000 children
Rate of Asthma:	In the schools that Mobile C.A.R.E. currently serves, our surveys show that the average rate of diagnosed asthma is approximately 16-19 percent. An additional 15 to 25 percent of students may have asthma that has not yet been diagnosed.
Number of Children Evaluated:	Almost 4,000
Number of Medical Appointments:	Over 19,000
Average Patient Age:	9 years old
Patient Gender:	Male 53 percent, Female 47 percent
Insurance Status :	60% Medicaid 11% uninsured 29% HMO/Partial Insurance (underinsured)
Race:	59% Latino 38% African-American 3% White or Other

Increase in Asthma Control

Asthma is considered controlled when symptoms are non-existent or minimal (e.g., coughing, wheezing, shortness of breath, needing albuterol). Because of the medical care, education, treatment plans and medications the Asthma Vans provide to our patients, many more patients are in control of their asthma after receiving our care.

Asthma Control 11/01/99 to 12/31/06
	Baseline (n=1,725)	Visit 3 (n=1,725)
% of Patients in Control of their Asthma	16 percent	78 percent

To summarize, Mobile C.A.R.E. services have resulted in a more than 350% increase in asthma control!

Reduction in Asthma Symptoms

Coughing, wheezing and shortness of breath are common symptoms of asthma. Mobile C.A.R.E. is able to significantly reduce the frequency of these symptoms after just three clinic visits.

Asthma Symptoms 11/01/99 to 12/31/06
% of Parents Reporting Symptom Less than 2 days/week and Less than 2 nights/month	Baseline (n=1,725)	Visit 3 (n=1,725)
Coughing:	41 percent	72 percent
Wheezing:	67 percent	89 percent
Shortness of Breath :	55 percent	80 percent
Note: Mobile C.A.R.E. asks parents/patients whether the child had an upper respiratory infection (URI) during the reporting period. The children represented in this table did not have a URI during the reporting period.

Reduced Resource Utilization

Going to the emergency room (ER) means an asthma treatment plan has failed. The next table shows that Mobile C.A.R.E. patients are visiting the emergency room less, meaning that their asthma is under control.

Emergency Room Visits For Asthma Attacks 11/01/99 to 12/31/06
	6 months prior to Asthma Van Care (n=1,310)	6 months post Asthma Van Care (n=1,310)
% of Patients with at least 1 ER Visit for asthma:	22 percent	11 percent

This shift from urgent care to outpatient, preventive care is attributed to patients' self management, patient education, and the clinic's 24-hour call service.

Another measure of resource usage is inpatient hospitalization. Mobile C.A.R.E. has also been able to reduce the number of hospitalizations for asthma attacks among our patients.

Hospitalizations Due To Asthma Attacks 11/01/99 to 12/31/06
	6 months prior to Asthma Van Care (n=1,310)	6 months post Asthma Van Care (n=1,310)
% of Patients with at least 1 Hospitalization for asthma:	5 percent	4 percent

To summarize, Mobile C.A.R.E. services have resulted in a significant reduction in resource utilization:

50 percent reduction in emergency room visits.
20 percent reduction in hospital admissions.

Better School and Work Attendance

In addition to symptom and resource utilization measures, Mobile C.A.R.E. collects parent-reported school attendance data. Patients' self-reported data are not as reliable as school data, but are more specific, since parents are asked for asthma-related absences only, whereas schools collect absence data for all reasons. Mobile C.A.R.E. patients are missing school due to asthma 60% less than before receiving our services.

School Absences Due To Asthma 11/01/99 to 12/31/06
	6 months prior to Asthma Van Care (n=1,310)	6 months post Asthma Van Care (n=1,310)
% of Patients Missing 5 or More Days of School due to asthma:	15 percent	6 percent

Because their children are healthy are staying in school, parents of Mobile C.A.R.E. patients likewise miss a less number of work days because of their child's asthma.

Positive Financial Impact of Mobile C.A.R.E. Foundation Asthma Vans

The data reported above demonstrates that Mobile C.A.R.E. services are helping children with asthma and their families. In addition, the data provide information on Mobile C.A.R.E.'s overall positive financial impact on society.

Health Care Resource Utilization:

A primary benefit of Mobile C.A.R.E. is related to a shift from acute, emergency treatment to preventive services. Prior to enrollment in the Mobile C.A.R.E. program, many patients relied on frequent hospital emergency room visits for their asthma care. Sometimes these children were also admitted to the hospital or intensive care unit. Mobile C.A.R.E. instead encourages families to control asthma using regular and preventive health care so that ER visits and hospitalizations are never necessary.

Of course, there will always be a need for emergency asthma treatment, but emergency treatment as the only therapy for asthma is not highly effective. According to the Chicago Asthma Surveillance Initiative (CASI) survey, Emergency Department personnel say that they have limited time and few resources to educate patients and families on preventive asthma treatment. So after a trip to the emergency room, the family returns to the same conditions that caused the original asthma crisis.

In contrast, Mobile C.A.R.E. is successful in disseminating, reinforcing and evaluating preventive asthma education. Based on cost-utility analysis, which includes parent preferences, Mobile C.A.R.E. offers the preferred service delivery solution, with a friendly and convenient setting for lower-cost services.

Indirect Costs of Lost School and Work Days:

Children with uncontrolled asthma miss school because of asthma flare-ups and/or persistent night time symptoms that disrupt a child's sleep. Parents of sick children often also miss work to care for them. By controlling asthma and thus reducing the need for missed school and work days, Mobile C.A.R.E. also saves hundreds of thousands of dollars per year in indirect costs to the school system and to employers.

“[My daughter] has become a pro at administering her medicine, she doesn't let a day or night go by without saying, Mom, it's time to take my medicine.”

“I think there should be more asthma Vans around.”