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The pediatric asthma intervention: a comprehensive cost-effective approach to asthma management in a disadvantaged
Paula Karnick1, Helen Margellos-Anast, Gloria Seals
1Sinai Children's Hospital. Chicago, Illinois 60608, USA.
Insights
Pediatric asthma interventions significantly reduced emergency care use and healthcare costs in inner-city children. Reinforced asthma education with case management showed the greatest health improvements and cost savings.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Public Health
Background:
- Inner-city children face significant asthma burdens.
- Effective interventions are needed to improve health outcomes and reduce healthcare utilization.
Purpose of the Study:
- To compare three pediatric asthma interventions.
- To assess their impact on health status and cost savings in inner-city children.
Main Methods:
- 212 children (1-16 years) randomized into three groups.
- Group 1: individualized asthma education.
- Groups 2 & 3: reinforced education with/without case management.
Main Results:
- All groups showed significant reductions in hospitalizations (81%), hospital days (69%), ED visits (64%), and clinic visits (58%).
- Group 3 (reinforced education + case management) demonstrated the greatest improvements.
- Cost savings ranged from $4,021 to $4,503 per child per year.
Conclusions:
- Asthma education, with or without case management, improves pediatric asthma health.
- These interventions lead to substantial reductions in healthcare costs.
Objective:
To compare three pediatric asthma interventions for their impact on improving the health status of inner-city asthmatic children and in achieving cost savings.
Study Design:
A total of 212 children 1 to 16 years of age were randomized into three groups: group 1 (n = 74) received one individualized asthma education session; group 2 (n = 68) received reinforced asthma education; group 3 (n = 70) received reinforced asthma education plus case management. Asthma-related health resource utilization and cost were primary outcomes. The cost-benefit analysis sought to estimate the expected cost savings to the Illinois Department of Healthcare and Family Services (Medicaid administrator) associated with the intervention.
Results:
Participants in all three groups used significantly fewer emergency health care services in the follow-up year. Averaged across all three groups, the magnitudes of declines were substantial: 81% for hospitalizations, 69% for hospital days, 64% for emergency department visits, and 58% for clinic visits. Although there were no statistically significant differences between study groups for three of the four main outcome measures, group 3 participants consistently improved to the greatest degree. All three interventions were associated with considerable cost savings ranging from $4,021/child/year for group 1 to $4,503/child/year for group 3.
Conclusion:
Asthma education with or without case management services enhances the health of children with asthma thereby reducing associated costs.
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