Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Cost of Asthma and Ways to Save Money With Further Health Care Reform

Category: Lagniappe - a little extra


With managed care rapidly approaching, there is much talk of the cost of treating asthma. The total cost is felt to be over $5 billion annually in America. Asthma seems to be increasing world-wide and the severity of asthma is increasing as well. Many studies published in the New England Journal of Medicine have shown that specialty treatment of asthma saves money because of better
control through patient education. 

In 1994, in Little Rock, Arkansas, the Pediatric Teaching Hospital studied a group of children admitted to the hospital with asthma.  They were placed in a special education group consisting of allergists and specialty allergy nurses. This team followed them and taught them how to control their asthma. This patient
group was ultimately compared to a control group which was treated through the regular hospital physicians. At the end of the year, there was a marked difference between the two groups. The group which received special protocol treatment with specialty medical
consultation and aggressive family education handled by the allergy specialists had markedly reduced time in the hospital. Their total hospital days for the year were significantly reduced. They were much more likely to be using anti-inflammatory agents (which are felt to be the key to asthma control). Their compliance (eg.
taking the recommended medications) was much higher than the control group. Finally, they were using multi-dose inhalers properly with spacer devices as compared to more costly nebulizers when compared to the control group. All of these measures were felt to save a cost of approximately $80,000 between the
respiratory care plan group and the control group. 

Most allergists around the world have felt that specialty care is important to the health of asthmatics and that no matter what happens with managed care, properly diagnosed asthma patients should be allowed to see specialists, either allergists or pulmonologists. This allows the optimal control of their disease. This study reminded me of how important patient education is for
controlling chronic diseases.