Outcomes evaluation of a comprehensive intervention program for asthmatic children enrolled in medicaid.
OBJECTIVE
To evaluate health care and financial outcomes in a population of Medicaid-insured asthmatic children after a comprehensive asthma intervention program.


METHODS
Controlled clinical trial.


METHODS
Pediatric allergy clinic in an urban, tertiary care children's hospital.


METHODS
Eighty children, 2 to 16 years old, with a history of frequent use of emergent health care services for asthma. Intervention. Children in the intervention group received asthma education and medical treatment in the setting of a tertiary care pediatric allergy clinic. An asthma outreach nurse maintained monthly contact with the families enrolled in the intervention group.


METHODS
Emergency department (ED) visits, hospitalizations, and health care charges per patient in the year after enrollment.


RESULTS
Baseline demographics did not differ significantly between the 2 groups. In the year before the study, there were no significant differences between intervention and control children in ED visits (mean, 3.5 per patient), hospitalizations (mean,.6 per patient) or health care charges ($2969 per patient). During the study year, ED visits decreased to a mean of 1.7 per patient in the intervention group and 2.4 in controls, while hospitalizations decreased to a mean of.2 per patient in the intervention group and.5 in the controls. Average asthma health care charges decreased by $721/child/year in the intervention group and by $178/patient/year in the control group.


CONCLUSIONS
A comprehensive asthma intervention program for Medicaid-insured asthmatic children can significantly improve health outcomes while reducing health care costs.asthma education, health care outcomes, Medicaid, asthma outreach, utilization.
Kelly
C S
CS
Division of Pulmonary, Allergy and Immunology, Eastern Virginia MedicalSchool, Norfolk, VA, USA. ckelly@chkd.com
Morrow
A L
AL
Shults
J
J
Nakas
N
N
Strope
G L
GL
Adelman
R D
RD
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D006801:Humans; D008484:Medicaid; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011788:Quality of Life; D012306:Risk; D014481:United States