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J Allergy Clin Immunol. 2005 Nov;116(5):1058-63. Epub 2005 Oct 3.

Cost-effectiveness of a home-based environmental intervention for inner-city children with asthma.

Author information

1
Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA. meyer.kattan@mssn.edu

Abstract

BACKGROUND:

Exposure to indoor allergens contributes to increased asthma morbidity. The Inner-City Asthma Study, a randomized trial involving home environmental allergen and irritant remediation among children aged 6 through 11 years with moderate-to-severe asthma, successfully reduced asthma symptoms. A cost-effectiveness analysis can help stakeholders to evaluate the potential costs and benefits of adopting such a program.

OBJECTIVE:

We sought to assess the cost-effectiveness of the environmental intervention of the Inner-City Asthma Study.

METHODS:

Incremental cost-effectiveness ratios for a 2-year study period were calculated. Health outcome was measured as symptom-free days. Resource use measures included ambulatory visits, hospitalizations, and pharmaceutical use. CIs were obtained by using bootstrapping.

RESULTS:

The intervention, which cost $1469 per family, led to statistically significant reductions in symptom days, unscheduled clinic visits, and use of beta-agonist inhalers. Over the year of the intervention and a year of follow-up, the intervention cost was $27.57 per additional symptom-free day (95% CI, $7.46-$67.42). Subgroup analysis showed that targeting the intervention to selected high-risk subgroups did not reduce the incremental cost-effectiveness ratio.

CONCLUSIONS:

A targeted home-based environmental intervention improved health and reduced service use in inner-city children with moderate-to-severe asthma. The intervention is cost-effective when the aim is to reduce asthma symptom days and the associated costs.

PMID:
16275376
DOI:
10.1016/j.jaci.2005.07.032
[Indexed for MEDLINE]
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