Following are brief synopsizes of the strategies identified by the working groups as most salient to their respective conditions (see Table 8-1). Audience feedback on the working groups’ proposals is summarized at the end of each section.



Asthma affects more than 20 million Americans, including 6.3 million children and adolescents. It is the sixth most common chronic condition in the United States, resulting each year in more than 4,400 deaths. Economic costs of the disease total $14 billion, $4.6 billion of which is due to lost productivity. Asthma is also the leading cause of school absenteeism due to a chronic illness. The strain on the health care system is immense. Yearly, asthma leads to 9.3 million physician visits, more than 400,000 hospitalizations, and more than 1.8 million emergency room visits (ALA, 2002).

The nation’s pediatric and minority populations bear the brunt of this disease; a disproportionate number of acute asthma attacks, deaths, hospitalizations, and emergency department visits are seen among children and racial minorities (ALA, 2002). In 2001, the highest prevalence rates of asthma were among those aged 5–17, with a rate of 98.1 cases per 1,000 children. Among African American patients, the prevalence of asthma was 22.7 percent higher than that among whites.

Key Strategies for High-Quality Asthma Care

The asthma working group identified the following strategies for overcoming current barriers to high-quality care for this disease:

  • Measurement and transparency

  • Information and communications technology

  • Finance and community collaboration

  • Patient/family control

Table 8-1. Key Strategies Identified by Condition-Specific Working Groups







Heart Failure

Pain Control



Information and Communications Technology



Patient/Family Control



Community Collaboration









Training and Education





Clinical Engagement





Public Awareness





Restructuring of Clinical Service Provision





Coordinated Leadership





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