Article

An economic evaluation of short-term inpatient rehabilitation for children with severe asthma.

Jefferson Medical College, Division of Allergy and Clinical Immunology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
Journal of Allergy and Clinical Immunology (impact factor: 11). 09/1996; 98(2):264-73. pp.264-73
Source: PubMed

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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    Article: Costs of asthma according to the degree of severity.
    J Serra-Batlles, V Plaza, E Morejón, A Comella, J Brugués
    [show abstract] [hide abstract]
    ABSTRACT: An increase in asthma-related morbidity and mortality has been reported recently, resulting in a substantial increase in the economic impact of this condition. Little information is available relating to the costs of asthma depending on the degree of severity of the disease. Total, direct and indirect costs generated by asthma patients who sought medical care for asthma control over a one-year period in a northern area of Spain were determined. Data were obtained from the patients themselves and severity of illness was classified into mild, moderate and severe according to the International Consensus Report on Diagnosis and Treatment of Asthma, 1992. The average total annual asthma-derived cost was estimated at US$2,879 per patient, with averages of US$1,336 in mildly asthmatic patients, US$2,407 in moderate asthma and US$6,393 in severe asthma. At all levels of severity, indirect costs were twice as high as direct costs, and at the same degree of severity, direct costs due to medication and hospitalization were higher among females than males. A minority of severe asthmatics incurred some 41% of the total costs. The cost of asthma was surprisingly high and varied substantially depending on the degree of severity of the disease. Further knowledge of the costs of asthma across various levels of severity will contribute to a better characterization of optimal intervention strategies for asthma care.
    European Respiratory Journal 01/1999; 12(6):1322-6. · 5.89 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

1-year period
 
4-year follow-up period
 
4-year postrehabilitation period
 
6.2 billion dollars
 
Asthma resource use
 
control group
 
discounted cumulative net savings surpassed
 
first year
 
fourth year
 
fourth years
 
mean rehabilitation charge
 
median asthma resource use 1 year
 
median emergency care
 
medical charges
 
own controls
 
postrehabilitation period
 
second year
 
severe asthma 1 year
 
third year
 
total medical charges