ArticleJournal of asthma and allergy2026
Implementation of an Institutional Asthma Care Guideline in Hospitalized Children: Effects on Clinical Outcomes and Healthcare Resource Utilization.
Article in Journal of asthma and allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute asthma exacerbations are a major cause of pediatric hospitalization and healthcare utilization. Despite the availability of standard guidelines, variability in inpatient management persists and may affect both clinical outcomes and resource use. Objective: To evaluate the impact of an institutional inpatient asthma care guideline on treatment processes, clinical outcomes, and hospitalization costs in children. Methods: This retrospective quality improvement cohort study included children aged 1-15 years hospitalized for acute asthma between 2016 and 2024. Patients were categorized into three phases: pre-implementation, post-implementation, and post-revision. The institutional guideline standardized bronchodilator escalation, respiratory support, and discharge planning, and was implemented using Plan-Do-Study-Act (PDSA) cycles. Results: A total of 220 children were included. Compared across the three phases, time to first bronchodilator decreased significantly (117 vs 104 vs 70 minutes, P < 0.001), with increased use of selected interventions, including nebulized steroids and high-flow nasal cannula (both P < 0.001). Differences in 24-hour clinical respiratory score reduction were observed across study phases, with adjusted analyses demonstrating greater improvement following guideline implementation. However, resource utilization increased after implementation, with longer hospital length of stay (47.5 vs 58.6 vs 67.3 h, P = 0.004) and higher hospitalization costs (249.7 vs 460.6 vs 447.0 USD, P < 0.001). Conclusion: Implementation of an institutional asthma care guideline was associated with improved treatment timeliness and early clinical improvement but was also associated with increased length of stay and hospitalization costs, suggesting a trade-off between clinical management and resource utilization.
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