Health care savings attributable to integrating guidelines-based asthma care in the pediatric medical home

Abstract

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).

Conclusion: 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.