May 27 2010
Approach Could Bring Enormous Savings in Healthcare Costs for Nine Million Children Living with Asthma in U.S.

In a newly published study, the Children’s Health Fund (CHF) and Columbia University’s Mailman School of Public Health report a savings of more than $4500 per child with asthma – or $11 saved for every one dollar spent – to the healthcare system with the use of a best-practice asthma intervention program in primary care for inner-city medically underserved children. The findings are published in a special supplement in the May Journal of Health Care for the Poor and Underserved.

IrwinRedlener_sidebar.jpgThe study found that treatment according to best-practice guidelines significantly reduces hospitalization and emergency room visits for asthma. In addition, the severity of asthma symptoms was reduced, including night-time symptoms that disrupt a child’s sleep and may interfere with school performance. Use of ‘best-practices’ treatment protocols is a component of the “medical home” model - comprehensive, consistent, coordinated care – rendering it so important that children with asthma have access to a medical home.

“In the wake of the passage of healthcare reform and a time of serious national economic duress, this study reinforces that providing comprehensive, high quality healthcare in the ‘medical home’ model is also the most economically sound in the long-term,” said Irwin Redlener, MD, president of the Children’s Health Fund & clinical professor of population and family health and pediatrics at Columbia University’s Mailman School of Public Health. “In fact, there are over nine million children living with asthma in the United States including more than two million who are living in poverty. These children are at particularly high risk for hospitalization and emergency room visits that could be prevented with access to quality asthma care, potentially resulting in enormous savings to the health system.”

Cost Savings

The total annual cost of the implementation at CHF’s New York program was $390,169, or $420 per asthma patient. The total annual savings attributable to clinical outcomes for this patient population was $4,202,813, or $4,525 per patient with asthma. Conservatively estimated savings exceeded cost of intervention by nearly 11 to 1. In this population the costs - and therefore the savings - were realized primarily by lower Medicaid expenditures. Dr. Redlener continues, “If we ensure access to healthcare and ‘best practice’ asthma treatment for children, especially those at high risk, there is the potential to save the healthcare system billions of dollars.” CHF studied 202 high-risk inner city children who are primary care patients of Children’s Health Fund’s New York program and found that, as a result of the primary care best-practice intervention, emergency room visits and hospital stays significantly declined, resulting in substantial savings to healthcare system. 

Children’s Health Fund’s Childhood Asthma Initiative was launched in New York City in 1997 and is currently implemented in CHF’s New York City and Washington, D.C. programs. The Initiative was established to increase access to healthcare and improve management of chronic asthma for thousands of medically underserved children and families. The program brings clinical care that is consistent with the most recent National Heart Lung and Blood Institute (NHLBI) ‘Best Practice’ Guidelines for the Diagnosis and Management of Asthma to children in poor communities where access to medical care is limited.