Pediatric Patients of Outreach Specialist Queensland Clinics Have Lung Function Improvement Comparable to That of Tertiary Pediatric Patients.


Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
10 2020
Historique:
received: 09 02 2020
revised: 04 03 2020
accepted: 28 03 2020
pubmed: 11 5 2020
medline: 4 6 2021
entrez: 11 5 2020
Statut: ppublish

Résumé

Inequitable access to quality health care contributes to the known poorer outcomes of people living in regional/remote areas (compared with urban-based), especially for First Nations people. Integration of specialist outreach services within primary care is one strategy that can reduce the inequity when modeled to the needs and available resources of target communities. To evaluate whether respiratory outreach clinics in regional and remote Queensland are as effective as tertiary respiratory services at improving the lung function of children. From existing databases, we obtained spirometry data of children (aged 3-18 years) seen at Indigenous-focused outreach clinics in regional and remote Queensland and Brisbane-based pediatric tertiary hospitals over the same contemporary period (October 2010 to July 2019). We compared the change in spirometry z scores (Δz) at follow-up for both groups of children. Lung function significantly improved in both groups: Tertiary hospital (n = 2,249; ΔzFEV Comparable significant lung function improvement of children was seen in Indigenous-focused outreach remote/regional clinics and paediatric tertiary hospitals. This suggests that effective clinical care is achievable within the outreach setting.

Sections du résumé

BACKGROUND
Inequitable access to quality health care contributes to the known poorer outcomes of people living in regional/remote areas (compared with urban-based), especially for First Nations people. Integration of specialist outreach services within primary care is one strategy that can reduce the inequity when modeled to the needs and available resources of target communities.
RESEARCH QUESTION
To evaluate whether respiratory outreach clinics in regional and remote Queensland are as effective as tertiary respiratory services at improving the lung function of children.
STUDY DESIGN AND METHODS
From existing databases, we obtained spirometry data of children (aged 3-18 years) seen at Indigenous-focused outreach clinics in regional and remote Queensland and Brisbane-based pediatric tertiary hospitals over the same contemporary period (October 2010 to July 2019). We compared the change in spirometry z scores (Δz) at follow-up for both groups of children.
RESULTS
Lung function significantly improved in both groups: Tertiary hospital (n = 2,249; ΔzFEV
INTERPRETATION
Comparable significant lung function improvement of children was seen in Indigenous-focused outreach remote/regional clinics and paediatric tertiary hospitals. This suggests that effective clinical care is achievable within the outreach setting.

Identifiants

pubmed: 32387516
pii: S0012-3692(20)30866-7
doi: 10.1016/j.chest.2020.03.084
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1566-1575

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Auteurs

Andrew J Collaro (AJ)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Centre for Children's Health Research, Queensland University of Technology, QLD, Australia. Electronic address: andrew.collaro@health.qld.gov.au.

Anne B Chang (AB)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Centre for Children's Health Research, Queensland University of Technology, QLD, Australia; Child Health Division, Menzies School of Health Research, NT, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, QLD, Australia.

Julie M Marchant (JM)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Centre for Children's Health Research, Queensland University of Technology, QLD, Australia.

Leanne T Rodwell (LT)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, QLD, Australia.

Ian B Masters (IB)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Centre for Children's Health Research, Queensland University of Technology, QLD, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, QLD, Australia.

Mark D Chatfield (MD)

Child Health Division, Menzies School of Health Research, NT, Australia; Faculty of Medicine, The University of Queensland, QLD, Australia.

Margaret S McElrea (MS)

Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, QLD, Australia; Centre for Children's Health Research, Queensland University of Technology, QLD, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, QLD, Australia.

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