Asthma, Rhinitis, Other Respiratory DiseasesThe cost-effectiveness of an inner-city asthma intervention for children☆,☆☆,★,★★
Section snippets
Methods
A cost-effectiveness evaluation of the NCICAS multicenter randomized trial was conducted by using a Medicaid payer perspective because the majority of children in the clinical trial were either recipients or eligible for Medicaid coverage. Outcomes, costs, and cost-effectiveness were analyzed over a 2-year period in accordance with the methodology principles for conducting economic evaluations outlined by the US Public Health Services panel on cost-effect-iveness in health and medicine.15
The
Results
Baseline characteristics of the children are shown in Table I.
No between-groupEmpty Cell Usual care group (n = 518) AC intervention group (n = 515) Male sex, % 66.0 62.1 Age, y (mean ± SD) 7.6 ± 1.8 7.7 ± 1.9 Race-ethnicity, % Black 73.1 75.9 Hispanic 17.4 17.1 Other 9.5 7 Had primary care physician, % 79.3 84.7 Household income <$15,000/y, % 66.0 68.9 Maximum symptom days (per 2 wk) 5.1 ± 4.6 5.1 ± 4.5 ≥1 hospitalization in past 2 mo, % 3.9 5.0
Discussion
Asthma morbidity remains a significant public health concern, especially in children living in the dense, urban areas of the United States. Randomized trials have now shown that educational and self-management efforts targeted toward these high-risk children can be effective. However, the cost-effectiveness of these programs had not previously been evaluated. Despite this, more resources continue to be directed toward families and children living in these settings.
We found that when compared
Acknowledgements
We thank Kristin Marciante, MPH, of the University of Washington for data analysis support.
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*A list of National Cooperative Inner-City Asthma Study, Phase II, investigators can be found in the Appendix.
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Supported by the National Institute of Allergy and Infectious Disease grants U01 A1-30751, A1-30752, A1-30756, A1-30772, A1-30773-01, A1-30777, A1-30779, A1-30780, and N01 A1-15105 and a research grant to the University of Washington from GlaxoSmithKline.
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This article does not represent the policy of the Agency for Healthcare Research and Quality. The views expressed are those of the authors, and no official endorsement by the Agency for Healthcare Research and Quality or the National Institutes of Health is intended or should be inferred.
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Reprint requests: Sean D. Sullivan, PhD, Departments of Pharmacy and Health Services, Box 357630, University of Washington, Seattle, WA 98195.