Health care education, delivery, and qualityCost-effectiveness of a home-based environmental intervention for inner-city children with asthma
Section snippets
Methods
Full details of the ICAS environmental intervention and outcome have been published previously.4, 5 The study was undertaken at 7 urban locations across the United States (Boston, Mass; Bronx, NY; Chicago, Ill; Dallas, Tex; New York, NY; Seattle, Wash; and Tucson, Ariz). Children aged 5 to 11 years who were diagnosed with asthma by a physician and had at least 1 positive skin test response to an indoor allergen were enrolled. Additional inclusion criteria were that the child had to have at
Results
A full assessment of the effect of the intervention on the child's asthma symptoms and pulmonary function and on the caretaker (eg, losing sleep or changing plans) has been published.4 Measures of average annual health service use over the 2-year study period are provided in Table II. The intervention reduced the number of unscheduled clinic visits by 0.24 per year (a 19% reduction relative to the control group) and reduced the number of β-agonist inhalers used per year by 0.86 (a 13%
Discussion
The ICAS home-based environmental intervention resulted in clinically significant improvement in health status and reductions in resource use among inner-city children with moderate-to-severe asthma. Over the 2 years of cost assessment, which included a year of intervention and a second year of follow-up only, the intervention cost was $27.57 per SFD gained. This study was carried out at 7 sites across the United States, making the findings generalizable to other inner-city populations in which
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Cited by (0)
Supported by grants AI-39769, AI-39900, AI-39902, AI-39789, AI-39901, AI-39761, AI-39785, and AI-39776 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, DHHS, and the National Institute of Environmental Health Sciences, National Institutes of Health, DHHS.
Disclosure of potential conflict of interest: R. Gruchalla has consultant arrangements with the GSK Allergy Fellowship Grant Review Board; receives grants from the National Institutes of Health, ExxonMobil, and Foundation support; and is employed by the US Food and Drug Administration. M. Kattan is on the speakers' bureau for Astra-Zeneca. W. Morgan has consultant arrangements with Genentech Inc. All other authors—none disclosed.