Community Health Worker Home Visits for Medicaid-Enrolled Children With Asthma: Effects on Asthma Outcomes and Costs.
OBJECTIVE
We sought to estimate the return on investment of a streamlined version of an evidence-based community health worker (CHW) asthma home visit program.


METHODS
We used a randomized parallel group trial of home visits by CHWs to Medicaid-enrolled children with uncontrolled asthma versus usual care.


RESULTS
A total of 373 participants enrolled in the study (182 in the intervention group and 191 in the control group, of whom 154 and 179, respectively, completed the study). The intervention group had greater improvements in asthma symptom-free days (2.10 days more over 2 weeks; 95% CI =  1.17, 3.05; P < .001) and caretakers' quality of life (0.43 units more; 95% CI = 0.20, 0.66; P < .001) and a larger reduction in urgent health care utilization events (1.31 events fewer over 12 months; 95% CI = -2.10, -0.52; P = .001). The intervention arm compared with the control arm saved $1340.92 for the $707.04 additional costs invested for the average participant. The return on investment was 1.90.


CONCLUSIONS
A streamlined CHW asthma home visit program for children with uncontrolled asthma improved health outcomes and yielded a return on investment of 1.90.
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
Jonathan D
JD
Campbell
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
Marissa
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Brooks
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
Patrick
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Hosokawa
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
June
J
Robinson
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
Lin
L
Song
Jonathan D. Campbell is with the Pharmaceutical Outcomes Research Graduate Program, Center for Pharmaceutical Outcomes Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Department of Clinical Pharmacy, Aurora. Marissa Brooks is with Service Employees International Union NW Health Benefits Trust, Seattle, WA. Patrick Hosokawa is with Colorado Health Outcomes, University of Colorado, Aurora. June Robinson, Lin Song, and James Krieger were with Public Health - Seattle & King County, Seattle, WA.
James
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Krieger
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000150:complications / Q000628:therapy*; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003150:Community Health Workers / Q000191:economics / Q000458:organization & administration*; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000706:statistics & numerical data; D006792:House Calls; D006801:Humans; D008297:Male; D008484:Medicaid; D010353:Patient Education as Topic / Q000458:organization & administration*; D011788:Quality of Life; D012648:Self Care; D016037:Single-Blind Method; D012959:Socioeconomic Factors; D014481:United States; D014861:Washington