title: Cost-benefit analysis of childhood asthma management through school-based clinic programs.
abstract: Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.
authors.affiliation: Department of Management, Quinnipiac University, 275 Mount Carmel Avenue, Hamden, CT 06518, USA. Teresa.W.Tai@quinnipiac.edu
authors.forename: Teresa
authors.initials: T
authors.lastname: Tai
authors.forename: Sherry I
authors.initials: SI
authors.lastname: Bame
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics; D001249:Asthma / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004632:Emergency Medical Services / Q000191:economics; D004651:Employment / Q000191:economics; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D015397:Program Evaluation; D012572:School Health Services / Q000191:economics*; D012573:School Nursing / Q000191:economics; D014481:United States / Q000453:epidemiology
references.citation: Arch Pediatr Adolesc Med. 2004 May;158(5):460-7
references.pmid: 15123479
references.citation: Health Serv Res. 2006 Jun;41(3 Pt 2):1061-80
references.pmid: 16704672
references.citation: Environ Health Perspect. 2002 Aug;110 Suppl 4:557-60
references.pmid: 12194886
references.citation: Dis Manag. 2004 Spring;7(1):61-75
references.pmid: 15035834
references.citation: Prev Chronic Dis. 2005 Jan;2(1):A11
references.pmid: 15670464
references.citation: J Sch Health. 2006 Aug;76(6):340-4
references.pmid: 16918868
references.citation: J Am Board Fam Pract. 2004 Mar-Apr;17(2):96-100
references.pmid: 15082667
references.citation: J Adolesc Health. 2005 Oct;37(4):266-74
references.pmid: 16182136
references.citation: Health Serv Res. 2006 Apr;41(2):532-49
references.pmid: 16584463
references.citation: Pediatrics. 2002 May;109(5):857-65
references.pmid: 11986447
references.citation: MMWR Surveill Summ. 2007 Oct 19;56(8):1-54
references.pmid: 17947969