title: Economic Evidence for US Asthma Self-Management Education and Home-Based Interventions.
abstract: The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (eg, higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments.
authors.affiliation: Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga. Electronic address: xdd6@cdc.gov.
authors.forename: Joy
authors.initials: J
authors.lastname: Hsu
authors.affiliation: Tufts University School of Medicine, Boston, Mass.
authors.forename: Natalie
authors.initials: N
authors.lastname: Wilhelm
authors.affiliation: Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, Ga.
authors.forename: Lillianne
authors.initials: L
authors.lastname: Lewis
authors.affiliation: Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Herman
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D001249:Asthma / Q000191:economics* / Q000628:therapy; D006699:Home Care Services / Q000191:economics; D006801:Humans; D010353:Patient Education as Topic / Q000191:economics; D012648:Self Care / Q000191:economics*; D014481:United States
keywords: Asthma; Community health worker; Control; Cost; Education; Home; Return on investment