Pediatric asthma continues to pose a significant challenge to population health. Despite more than 25 years of management guidelines¹ from the National Heart, Lung, and Blood Institute and the wide availability of effective controller medications, asthma morbidity rates in the United States have stagnated.² In this issue of JAMA Pediatrics, Kercsmar et al³ detail the influence of a triphasic quality improvement initiative on asthma outcomes in a population of Medicaid-insured children and adolescents (aged 2-17 years) in Hamilton County, Ohio. The 3 domains of bundled quality improvement (QI) interventions (inpatient, outpatient, and community) were sequentially implemented during a 5-year period and engaged a multidisciplinary team grounded in the chronic care model.

小儿哮喘继续对人群健康构成重大挑战。尽管美国国家心脏，肺和血液研究所已有超过25年的管理指南¹，并且广泛使用了有效的控制药物，但美国的哮喘发病率却停滞不前。²在本期《美国医学会杂志》（JAMA）儿科杂志中，Kercsmar等人³详细介绍了在俄亥俄州汉密尔顿县接受医疗补助的儿童和青少年（2至17岁）人群中，三项质量改进计划对哮喘结局的影响。在5年内依次实施了捆绑式质量改善（QI）干预措施的3个领域（住院，门诊和社区）​​，并邀请了一个建立在慢性病治疗模式基础上的跨学科团队。