title: Health care savings attributable to integrating guidelines-based asthma care in the pediatric medical home.
abstract: OBJECTIVE
  To estimate savings to health care system of a best-practice asthma intervention in primary care for inner-city children.
  
  
  METHODS
  Data were analyzed from National Heart, Lung and Blood Institute (NHLBI) Guidelines-based initial (n=244) and follow-up (n=202) asthma assessments of patients who received enhanced treatment in primary care. Savings were calculated using cost-of-illness model and compared with program cost.
  
  
  RESULTS
  Patients were about equally distributed between African American and Hispanic children (mean age = 7 years; range 36 months-19 years). Of those with persistent asthma, 36% had been prescribed a controller medication. This significantly improved on follow-up (p<.01). There were significant reductions in asthma severity (p<.05) and emergency department use (p<.01), and near-significant reduction in asthma hospitalizations (p=.059).
  
  
  CONCLUSIONS
  Total annual savings attributable to clinical outcomes was $4,202,813 or $4,525 per patient with asthma. Total annual cost of the implementation was $390,169 or $420 per asthma patient. Conservatively estimated savings exceeded cost of intervention by nearly 11 to 1.
authors.affiliation: Children's Health Fund, New York, NY 10027, USA. rgrant@chfund.org
authors.forename: Roy
authors.initials: R
authors.lastname: Grant
authors.forename: Shawn K
authors.initials: SK
authors.lastname: Bowen
authors.forename: Matthew
authors.initials: M
authors.lastname: Neidell
authors.forename: Timothy
authors.initials: T
authors.lastname: Prinz
authors.forename: Irwin E
authors.initials: IE
authors.lastname: Redlener
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D001249:Asthma / Q000191:economics / Q000208:ethnology / Q000628:therapy*; D002648:Child; D002662:Child Health Services / Q000191:economics*; D002675:Child, Preschool; D017046:Cost Savings / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D009519:New York City; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000191:economics*; D012720:Severity of Illness Index; D014505:Urban Population; D055815:Young Adult