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UNDERSERVED POPULATIONS: CHILDHOOD ASTHMA AND LIFE IN PHILLY TOWN

Highlights From the ATSP Telehealth Conference 2002: Briefings on Telemedicine Activity in the US and Abroad During the Past 12 Months September 9-12, 2002, Teleconference

Connecting public health centers to state-supported teaching hospitals could lower the number of days that children with asthma miss school and could make better use of the children's insurance program in Pennsylvania.

Many poor children with asthma have severely impeded access to quality healthcare due to limits on transportation and other resources. Dr. Mitchell noted that asthma is now the number-one cause of hospitalization among children under the age of 15 in the United States, and asthma is considered the factor responsible for 10 million lost school days annually.

But a flare-up of the chronic respiratory disease does not mean that children must miss school, Dr. Mitchell said. "Seventy percent of asthma hospitalizations for children could be cared for in alternate settings with close nurse observation." He described a school-based setting equipped with a fiber-optics communication network that would allow a healthcare professional to monitor asthmatic children 1-2 times per week. Pennsylvania's CHIP program could pay for some or part of the program, Dr. Mitchell said. In fiscal 1999, $40.7 million in federal funding for the federal-state program was returned to federal coffers unspent, he said.

To put his estimated half-million dollar program into place, Dr. Mitchell proposed that $175,000 be used to connect public health clinics to state hospitals and determine billing and other communication costs. An additional $176,000 would be spent to acquire telemedicine equipment; $77,000 to determine physician scheduling, reimbursement policy, and procedures; and $73,000 to pay doctors for their services. In contrast, national expenditures for hospitalizations of asthmatic patients under age 18 run an estimated $3.2 billion per year.

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