An economic evaluation of short-term inpatient rehabilitation for 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.


CONCLUSIONS
Inpatient rehabilitation was significantly associated with a reduction in estimated total medical charges over a 4-year follow-up period.
Weinstein
A G
AG
Jefferson Medical College, Division of Allergy and Clinical Immunology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
McKee
L
L
Stapleford
J
J
Faust
D
D
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000191:economics* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000191:economics; D004470:Economics, Medical; D005251:Fees, Medical; D005500:Follow-Up Studies; D017722:Hospital Charges; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000191:economics; D007902:Length of Stay / Q000191:economics*; D010290:Parents; D010343:Patient Admission / Q000191:economics*; D012017:Referral and Consultation; D013038:Specialization