Visiting Asthma at Home is a Success

Home visits for low income families were cost effective and improved asthma symptoms

(RxWiki News) Children in low-income areas have an increased risk of developing asthma. A new community-based program has been successful in helping to control asthma.

A Boston-based community program has been successful in managing children's asthma in low-income areas. The program involved education, in-home care, and case workers working with families and children.

The efforts were successful in reducing hospitalizations and saving $1.46 for every dollar spent.

"Ask your doctor about asthma programs in your area."

The Community Asthma Initiative (CAI) was led by Elizabeth Woods, M.D., M.P.H., of the Division of Adolescent/Young Adult Medicine, and Shari Nethersole, M.D., of the Office of Child Advocacy at Children's Hospital Boston.

The CAI involved 283 families from four different low-income neighborhoods. The CAI began in 2005 and 43 percent of the children had moderate to severe asthma. In just one year, the children had their emergency room visits reduced by 68 percent.

The CAI included bilingual nurses and case management that helped educate families about asthma and environmental triggers. Families were provided HEPA vacuums, bedding encasements to reduce dust mite irritants and pest control services.

Environmental factors were the biggest trigger for families which included pests and mold.

In addition to the 43 percent decrease in emergency room visits, there was a 85 percent decrease in hospitalizations. Missed school days were down by 41 percent, missed days of work for parents was down 50 percent and a 43 percent decrease in the number of children whose physical activity was limited due to asthma. By the end of one year, 82 percent of children had an up-to-date asthma care plan.

The positive impact lasted for two years after the CAI was completed.

Aside from the improvements for families and children, there was a significant economic improvement for children in the CAI. While the program cost $2,529 per child for the year, families saved $1.46 for every dollar spent. The reason was due to the decrease in hospitalizations and emergency room visits.

When researchers factored in the hospitalizations and emergency room visits, asthma cost children $3,827 a year. That is a substantial economic gain for low-income families and the reduction of missed days of work can also factor into the savings.

Some limitations of the study included lack of insurance information as well as data from hospital and pharmacy care. The researchers also believe the true savings were greater because the CAI did not factor in physician fees or financial savings for families.

For the future, these community-based programs can be factored into insurance policies which can save families money for asthma care. Not only will families save money but children will be able to get the best possible asthma care available. Community-based programs bring much needed relief to high-risk asthma patients that not only improves treatment but is cost-effective.

This study was funded by a REACH US grant from Centers for Disease Control and Prevention, Healthy Tomorrows from the Health Resources and Services Administration and the Ludcke, BJ's, Covidien and Thoracic Foundations. No author conflicts were reported.

This study was published in the March edition of Pediatrics.