Emergency Room Encounters of Pediatric Patients with Asthma: Cost Comparisons with Other Treatment Settings

Abstract

More than 67,000 claims from a national database were analyzed to determine the relative costs of treating pediatric patients with asthma in physicians' offices, hospital outpatient departments, or emergency rooms. Billed charges and paid claims for these cases in emergency rooms average more than 5 times higher than in physician offices. Emergency treatment generally results from a failure of proper management and education in the primary care setting. Educational programs for pediatric patients with asthma and their families could save resources as well as reduce the trauma often associated with visits to the emergency room.

Improved overall trends but persistent racial disparities in emergency department visits for acute asthma, 1993-2005

“…Most ED visits for acute asthma represent a treatment or maintenance failure 8,15 and are believed to be preventable through longitudinal disease management undertaken by both medical providers and the patient. 16,17 Rising trends in asthma morbidity in the 1980s and 1990s 2 led to publication and widespread distribution of NAEPP guidelines in 1991, 1997, 2002, and most recently in 2007.…”

“…6 ED visits for acute asthma are particularly disturbing because effective therapy is available, and ED treatment for asthma tends to be more costly and inconsistent than treatment in the outpatient office setting. 7,8 For these reasons, the Centers for Disease Control identified the reduction of hospital ED visits for asthma as a national objective in Healthy People 2010. 18 The results of our study suggest that, after a peak in asthmarelated ED visits at 7.6 per 1000 persons in 1998, the rate has subsequently stabilized (and possibly decreased) to 6.0.…”

“…2 Furthermore, ED visits add significantly to the financial burden of asthma, costing as much as 5 times more per visit than outpatient office visits for asthma. 7,8 Understanding and describing the trends in asthma-related ED visits may provide further insight into the recent trends in asthma mortality, morbidity, and management. Therefore, in this article, we describe national annual estimates and trends of asthmarelated ED visits that occurred between 1993 and 2005.…”

Cost-effectiveness of omalizumab in adults with severe asthma: Results from the Asthma Policy Model

“…Costs-Costs were estimated from published resource use studies [29][30][31][32][33][34][35][36] and adjusted to reflect US 2005 dollars by using the Consumer Price Index. 21 Baseline monthly chronic care costs (medications, routine office visits, laboratory testing) were $77 for patients with severe disease.…”

Emergency department visits for acute asthma by adults who ran out of their inhaled medications

“…1 Recent national estimates indicate that there are 2 million asthma emergency department (ED) visits each year. [1][2][3] This patient population is a cause for concern because most asthma-related ED visits represent a treatment or maintenance failure 4,5 and are deemed to be preventable through longitudinal disease management undertaken by both medical providers and the patient. 6,7 Furthermore, ED visits impose a heavy economic burden on health care spending as much as five times more per visit than a typical outpatient office visit for asthma.…”