ABSTRACT
With the apparent increase in the prevalence of asthma, there have been associated increases in deaths from acute asthma and in hospital admissions. In 1989, an integrated care scheme was implemented for patients with moderately severe asthma regularly attending outpatient chest clinics in Aberdeen, Banff, Elgin, and Peterhead. There were no statistically significant differences between the two randomized groups on entry to the study. No differences between the groups were recorded in the results for the psychosocial outcomes assessed after 1 year. Patients' perceptions of integrated care for asthma were recorded at interview. For integrated care patients, however, a large saving in overall costs was recorded, mainly through a reduction in travelling expenses and reduced periods of time devoted to visiting hospital clinics. The development of integrated care appears to have been hindered by the lack of empirical evidence supporting its clinical, as well as its cost-effectiveness.
