The pediatric asthma intervention: a comprehensive cost-effective approach to asthma management in a disadvantaged inner-city community.
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.


METHODS
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.


CONCLUSIONS
Asthma education with or without case management services enhances the health of children with asthma thereby reducing associated costs.
Karnick
Paula
P
Sinai Children's Hospital. Chicago, Illinois 60608, USA.
Margellos-Anast
Helen
H
Seals
Gloria
G
Whitman
Steve
S
Aljadeff
Gabriel
G
Johnson
Daniel
D
D000293:Adolescent; D001741:Black or African American; D001249:Asthma / Q000191:economics* / Q000208:ethnology / Q000628:therapy*; D019090:Case Management / Q000458:organization & administration; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid / Q000458:organization & administration; D010353:Patient Education as Topic / Q000379:methods*; D019037:Urban Health Services / Q000191:economics* / Q000458:organization & administration