Asthmatic children whose families receive a house call from a nurse or clinician are more likely to do better, spend less time in a hospital and cost significantly less in heath-care expenditures, a new study has found.
Clinicians at Children's Hospital Boston, reporting in the journal Pediatrics, said a program called the Community Asthma Initiative dramatically reduced hospital care for children in the program -- saving $1.46 per dollar spent on health care through reduced hospital utilization.
Nearly 1 in 10 children have asthma, according to government statistics, and that rate is higher in low-income urban areas.
The CAI is a community-based asthma care program that uses home visits by a bilingual nurse or health worker to educate families about asthma, assess the home for asthma triggers and provide materials and services to improve the home environment, such as encasements for bedding, HEPA vacuums and pest control.
The new study involved 283 families that agreed to participate in the program. At enrollment, 43 percent of participating children had asthma scored as moderate or severe. Families received an average of 1.2 home visits during the year-long program.
After 12 months in the program, researchers found:
• The children had a 68 percent decrease in asthma-related emergency department visits and an 85 percent drop in hospitalizations.
• There was a 43 percent reduction in the percentage of children who had to limit physical activity on any day, a 41 percent reduction in reports of missed school.
• A 50 percent reduction in parents having to miss work to care for their child.
• The program cost $2,529 per child, but yielded a savings of $3,827 per child because of reduced hospital visits and admissions.
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