Health care savings attributable to integrating guidelines-based asthma care in the pediatric medical home.
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.
Grant
Roy
R
Children's Health Fund, New York, NY 10027, USA. rgrant@chfund.org
Bowen
Shawn K
SK
Neidell
Matthew
M
Prinz
Timothy
T
Redlener
Irwin E
IE
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