The effect of a pediatric asthma management program provided by respiratory therapists on patient outcomes and cost

Shelledy, David C.; McCormick, Shawn R.; LeGrand, Terry S.; Cárdenas, Jaime; Peters, Jay I.

doi:10.1016/j.hrtlng.2005.05.004

Cited by 30 publications

(25 citation statements)

References 18 publications

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“…Our results are consistent with three previous cost-benefit analyses applying environmental education strategies on the reduction of asthma outcomes (15, 22, 29, 30). These trials had employed either the single or the multi-component strategy with varying levels of net cost savings.…”

Section: Discussionsupporting

confidence: 92%

“…These trials had employed either the single or the multi-component strategy with varying levels of net cost savings. Notably, only one of the three studies fulfilled the inclusion criteria of our review (22). Whereas these prior studies aimed for more local relevance, we took an approach (e.g., the use of national salary and statewide health encounter data) that sought to maximize the generalizability of our results.…”

Section: Discussionmentioning

confidence: 99%

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Cost-Consequence Analysis of Multimodal Interventions with Environmental Components for Pediatric Asthma in the State of Maryland

Jassal¹,

Diette

Dowdy

2013

Journal of Asthma

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Background Applied environmental strategies for asthma control are often expensive, but may save longer-term healthcare costs. Whether these savings outweigh additional costs of implementing these strategies is uncertain. Methods We conducted a systematic review to estimate the expenditures and savings of environmental interventions for asthma in the state of Maryland. Direct costs included hospitalizations, emergency room, and clinic visits. Indirect expenditures included costs of lost work productivity and travel incurred during the usage of healthcare services. We used decision analysis, assuming a hypothetical cohort of the approximated 49,290 pediatric individuals in Maryland with persistent asthma, to compare costs and benefits of environmental asthma interventions against the standard of care (no intervention) from the societal perspective. Results Three interventions among nine articles met the inclusion criteria for the systematic review: 1) environmental education using medical professionals; 2) education using non-medical personnel; and 3) multi-component strategy involving education with non-medical personnel, allergen-impermeable covers, and pest management. All interventions were found to be cost-saving relative to the standard of care. Home environmental education using non-medical professionals yielded the highest net savings of $14.1 million (95% simulation interval (SI): $−.283 million, $19.4 million), while the multi-component intervention resulted in the lowest net savings of $8.1 million (95% SI: $−4.9 million, $15.9 million). All strategies were most sensitive to the baseline number of hospitalizations in those not receiving targeted interventions for asthma. Conclusions Limited environmental reduction strategies for asthma are likely to be cost-saving to the healthcare system in Maryland and should be considered for broader scale-up in other economically similar settings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Cost-Consequence Analysis of Multimodal Interventions with Environmental Components for Pediatric Asthma in the State of Maryland

Jassal¹,

Diette

Dowdy

2013

Journal of Asthma

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“…Some studies, including randomized trials, identified cost savings [12][13][14][15] while others discovered no cost benefit [16][17][18]. Fitzner et al [19] surveyed 57 commercial disease management programs and found that returns on investment of diabetes and asthma programs range from 0.16:1 to 4:1.…”

Section: Cost Savings and Patient Utilizationmentioning

confidence: 99%

Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries

et al. 2008

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“…The findings were similar to what we found in most of the literature. For clinical improvement, our study showed lower hospital utilization, ER, OPD, and readmissions for all kinds of patients, especially those requiring HRT [14][15][16]. In this study, in addition to hospital utilization, we used the GCS as one of the objective clinical measures to assess patient health improvement; these figures reflected improvement in the score, but were not statistically significant (p > 0.05).…”

Section: Discussionmentioning

confidence: 96%

Evaluation of home respiratory therapy delivered to patients in the Ministry of Health’s Home Medical Program (HMP) and administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013

Alhelali¹,

McNabb²,

Memish³

2015

JEGH

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This was an evaluation of home respiratory therapy (HRT) services administered through the Madinah Home Medical Program (MHMP) Center of the Ministry of Health (MoH), Kingdom of Saudi Arabia (KSA). Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60 years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease (11%). Most patients (71%) required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room (ER) and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization.

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The effect of a pediatric asthma management program provided by respiratory therapists on patient outcomes and cost

Cited by 30 publications

References 18 publications

Cost-Consequence Analysis of Multimodal Interventions with Environmental Components for Pediatric Asthma in the State of Maryland

Cost-Consequence Analysis of Multimodal Interventions with Environmental Components for Pediatric Asthma in the State of Maryland

Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries

Evaluation of home respiratory therapy delivered to patients in the Ministry of Health’s Home Medical Program (HMP) and administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013

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