title: Cost-effectiveness of the School-Based Asthma Therapy (SBAT) program.
abstract: OBJECTIVE
  Impoverished urban children suffer disproportionately from asthma and underuse preventive asthma medications. The objective of this study was to examine cost-effectiveness (CE) of the School-Based Asthma Therapy (SBAT) program compared with usual care (UC).
  
  
  METHODS
  The analysis was based on the SBAT trial, including 525 children aged 3 to 10 years attending urban preschool or elementary school who were randomized to either UC or administration of 1 dose of preventive asthma medication at school by the school nurse each school day. The primary outcome was the mean number of symptom-free days (SFDs). The impact of the intervention on medical costs was estimated by using parent-reported child health services utilization data and average national reimbursement rates. We estimated the cost of running the program using wages for program staff. Productivity costs were estimated by using value of parent lost time due to child illness. CE of the SBAT program compared with UC was evaluated based on the incremental CE ratio.
  
  
  RESULTS
  The health benefit of the intervention was equal to ∼158 SFD gained per each 30-day period (P < .05) per 100 children. The programmatic expenses summed to an extra $4822 per 100 children per month. The net saving due to the intervention (reduction in medical costs and parental productivity, and improvement in school attendance) was $3240, resulting in the incremental cost-savings difference of $1583 and CE of $10 per 1 extra SFD gained.
  
  
  CONCLUSIONS
  The SBAT was effective and cost-effective in reducing symptoms in urban children with asthma compared with other existing programs.
authors: Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA. katia_noyes@urmc.rochester.edu
authors: Katia
authors: K
authors: Noyes
authors: Alina
authors: A
authors: Bajorska
authors: Susan
authors: S
authors: Fisher
authors: Joseph
authors: J
authors: Sauer
authors: Maria
authors: M
authors: Fagnano
authors: Jill S
authors: JS
authors: Halterman
mesh_terms: D001249:Asthma / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000379:methods / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012574:Schools / Q000191:economics*; D014505:Urban Population / Q000639:trends
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