Table 3.
Processes and outcomes of care among ED patients with acute asthma, according to provider type
| Variable | Physician | Supervised MLP | Unsupervised MLP | P |
|---|---|---|---|---|
| No. of patients eligible (% care given) | ||||
| Processes of care (level of evidence) | ||||
| Prescribing inhaled β-agonists in ED (A) | 3622 (91) | 319 (95) | 88 (84) | .006 |
| Prescribing inhaled anticholinergics in ED (A) | 1147 (78) | 105 (73) | 9 (78) | .56 |
| Not prescribing methylxanthines in ED (A) | 3621 (99) | 319 (99) | 88 (100) | .06 |
| Prescribing systemic corticosteroids in ED (A) | 1891 (78) | 181 (78) | 31 (48) | <.001 |
| Prescribing oral corticosteroids at discharge (A) | 1204 (66) | 115 (72) | 29 (45) | .02 |
| Not prescribing antibiotics in ED (B) | 3438 (92) | 303 (90) | 83 (93) | .40 |
| Not prescribing oral antibiotics at discharge (B) | 2804 (83) | 224 (80) | 83 (76) | .09 |
| Assessment of PEF (B) | 3247 (51) | 299 (67) | 87 (49) | <.001 |
| Timeliness measures (level of evidence) | ||||
| Initial PEF ≤30 min of arrival (B) | 1409 (48) | 176 (43) | 36 (28) | .02 |
| Posttreatment PEF within 30–90 min (B) | 3440 (21) | 300 (30) | 85 (25) | .004 |
| Inhaled β-agonists ≤15 min of arrival | 3092 (29) | 285 (28) | 70 (4) | <.001 |
| Systemic corticosteroids ≤75 min of arrival | 1394 (62) | 131 (62) | 15 (33) | .07 |
| Physician | Supervised MLP | Unsupervised MLP | P | |
| (n = 3622) | (n = 319) | (n = 88) | ||
| Composite score | ||||
| Composite guideline concordance score, median (IQR) | 64 (57–75) | 67 (57–82) | 57 (50–67) | <.001 |
| Outcomes of care | ||||
| ED length of stay, median (IQR), min | 175 (116–276) | 165 (112–267) | 151 (111–205) | .049 |
| Hospital admission, %* | 19 | 21 | 2 | <.001 |
*
Included patients admitted to ward, observation unit, or intensive care unit.