AN INTERVENTION PROGRAM TO REDUCE THE HOSPITALIZATION COST OF ASTHMATIC-PATIENTS REQUIRING INTUBATION

Background: Asthma is the single disease that accounts for the largest proportion of total health care cost in the US. Objective: To analyze whether an asthma management program affected the cost of subsequent asthma care for patients in whom intubation had been necessary. Method s: We evaluated patients with asthma who (1) had required intubation f or treatment of status asthmaticus; (2) were 45 years old or younger; (3) had regular follow-up visits in our clinic for 1 year after initia l evaluation; and (4) had complete medical records 1 year before and 1 year after the intervention for our evaluation. Medical costs of asth ma treatment for each patient were determined for 1 year before and 1 year after intervention. The program included patient education, regul ar outpatient visits, specialist care, and access to the Allergy Immun ology emergency call service. The outcome measures were the total cost of care, inpatient hospitalizations, outpatient services, emergency s ervices, and medicine costs. Results: Nine patients [mean age 19.6 yea rs (SD = 9.9)] fulfilled the criteria (six women and three men). The m ean duration of asthma was 14.0 years (SD = 9.7). The mean total cost of care decreased from $43,066 to $4,914 (t = -4.53, P < .001) and inp atient hospitalization costs decreased from $40,253 to $1,926 (t = -4. 50, P < .001). There was, however, no significant difference in the me an pre-intervention versus post-intervention cost of emergency service s, outpatient services, or medicine costs. Conclusions: The interventi on-which included education, specialist care, regular outpatient visit s, and access to an emergency call service-si,gnificantly reduced the cost of asthma care in our population of patients intubated for asthma .