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Published on: November 5, 2010
An economic evaluation of short-term inpatient rehabilitation for children with severe asthma
A G Weinstein1, L McKee, J Stapleford
1Jefferson Medical College, Division of Allergy and Clinical Immunology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
Insights
Inpatient rehabilitation significantly reduced medical charges for children with severe asthma. This approach offered substantial cost savings over four years, improving asthma care management.
Area of Science:
- Pediatric Pulmonology
- Health Economics
- Rehabilitation Medicine
Background:
- Asthma care in the US incurred substantial costs in 1990, largely from hospitalizations.
- Severe asthma in children presents a significant financial burden on healthcare systems.
Purpose of the Study:
- To evaluate the impact of inpatient rehabilitation on medical charges for children with severe asthma.
- To assess changes in healthcare resource utilization and associated costs over a four-year follow-up period.
Main Methods:
- Retrospective and prospective analysis of asthma resource use (hospital, physician, medication) for 59 children.
- Estimated medical charges were calculated for the year pre-rehabilitation and four years post-rehabilitation.
- Patients served as their own controls, comparing pre- and post-intervention costs.
Main Results:
- Significant reductions in hospitalizations and emergency care visits were observed post-rehabilitation.
- Mean total medical charges decreased by 56.7% in year 1, 70.5% in year 2, 74.6% in year 3, and 77.5% in year 4.
- Discounted cumulative net savings reached $29,605 over four years, with costs recouped within the fourth year.
Conclusions:
- Inpatient rehabilitation is a cost-effective intervention for severe pediatric asthma.
- The study demonstrates a significant association between inpatient rehabilitation and reduced medical expenditures in children with severe asthma.
Background:
The cost of asthma care in the United States in 1990 has been estimated to be 6.2 billion dollars. The greatest proportion is due to hospital care.
Objective:
We report changes in estimated medical charges of 59 children with severe asthma 1 year before inpatient rehabilitation and over a 4-year follow-up period.
Methods:
Asthma resource use (e.g., hospital, physician, medication) was identified before and after inpatient rehabilitation. Estimated charges were assigned. This was done retrospectively for the 1-year period before rehabilitation, prospectively during rehabilitation, and over a 4-year follow-up period. Patients served as their own controls. There was no control group.
Results:
When median asthma resource use 1 year before rehabilitation was compared with that during the first, second, third, and fourth years of follow-up, there was a reduction in median hospitalization and median emergency care. Compared with mean total medical charges the year before rehabilitation, reductions in mean total medical charges were 56.7% at the completion of the first year (excluding charges for rehabilitation), 70.5% at second year, 74.6% at third year, and 77.5% at fourth year. Over the 4-year postrehabilitation period, the discounted cumulative net savings was $29,605. The discounted cumulative net savings surpassed the mean rehabilitation charge during the early months of the fourth year of the postrehabilitation period.
Conclusion:
Inpatient rehabilitation was significantly associated with a reduction in estimated total medical charges over a 4-year follow-up period.
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