An economic evaluation of short-term inpatient rehabilitation for children with severe asthma.
ABSTRACT The cost of asthma care in the United States in 1990 has been estimated to be 6.2 billion dollars. The greatest proportion is due to hospital care.
We report changes in estimated medical charges of 59 children with severe asthma 1 year before inpatient rehabilitation and over a 4-year follow-up period.
Asthma resource use (e.g., hospital, physician, medication) was identified before and after inpatient rehabilitation. Estimated charges were assigned. This was done retrospectively for the 1-year period before rehabilitation, prospectively during rehabilitation, and over a 4-year follow-up period. Patients served as their own controls. There was no control group.
When median asthma resource use 1 year before rehabilitation was compared with that during the first, second, third, and fourth years of follow-up, there was a reduction in median hospitalization and median emergency care. Compared with mean total medical charges the year before rehabilitation, reductions in mean total medical charges were 56.7% at the completion of the first year (excluding charges for rehabilitation), 70.5% at second year, 74.6% at third year, and 77.5% at fourth year. Over the 4-year postrehabilitation period, the discounted cumulative net savings was $29,605. The discounted cumulative net savings surpassed the mean rehabilitation charge during the early months of the fourth year of the postrehabilitation period.
Inpatient rehabilitation was significantly associated with a reduction in estimated total medical charges over a 4-year follow-up period.
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ABSTRACT: Background Nonadherence to asthma treatment has been related to increased hospital and emergency care, morbidity, and unnecessary costs. Improving patient adherence is a key component to achieving optimal outcomes. Objective Review barriers, interventions, and communication skills shown to be effective in promoting asthma adherence. Methods Asthma adherence literature was reviewed. Results Sequential management principles to achieve adherence include the following: (1) measuring adherence, (2) identifying barriers that result in nonadherence, (3) using specific strategies to overcome barriers; and (4) using communication skills to enhance the delivery of selected strategies. Conclusion Careful attention to adherence management principles may increase adherence, enhance outcomes, and reduce unnecessary morbidity and cost. The case described applies these principles and gives the reader a framework to review.The Journal of Allergy and Clinical Immunology: In Practice. 03/2013; 1(2):123–128.