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Children’s Hospital reports progress on asthma

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February 20, 2012|By Kay Lazar

Chanese Brown and her son Thomas, who just went on his first out-of-state… (Kayana Szymczak for the…)

Hospitalizations for asthma have been dramatically cut by a program that helps families reduce the conditions that trigger attacks, saving $1.46 in hospital care for every $1 spent on prevention, according to a Children’s Hospital Boston study being released today.

The hospital’s program, the Community Asthma Initiative, targeted 283 children with asthma in some of Boston’s poorest neighborhoods. Health workers taught families how to correctly use medications and eliminate triggers of attack, such as contaminated bedding and feather dusters. They also provided each family a vacuum cleaner with special filters.

After the first year, asthma-related emergency room visits for children in the program plummeted 68 percent compared with their emergency room trips in the year before enrolling, and there was an 85 percent drop in hospitalizations, according to the study published online in the journal Pediatrics.

Additionally, there was a 43 percent decrease in the number of children who had to limit physical activity and a 41 percent reduction in reports of missed school days. For their parents, that translated into a 50 percent drop in the time they had to miss work to care for ailing youngsters, the study found.

The results are so promising that Massachusetts Medicaid officials are working with the Children’s Hospital team to develop a similar plan to improve care and reduce costs statewide for children covered by the health insurance program for low-income residents. Asthma rates are disproportionately higher in poor neighborhoods.

The researchers compared the participants’ medical costs with those of asthmatic children from four similar, nearby communities who were not in the program. The program cost $2,529 per child, but because of fewer ER visits and hospital admissions, medical spending per child was $3,827 less than for children in the other communities over two years of follow-up. That translates to a $1.46 savings for every $1 spent.

“It’s very gratifying to see improved health outcomes for children and for families and also to be able to demonstrate cost savings,’’ said the study’s lead author, Dr. Elizabeth R. Woods, associate chief of adolescent/young adult medicine at Children’s.

Woods said her team was surprised at the extent of environmental issues they found in homes.

“Most didn’t have vacuums and couldn’t afford them,’’ Woods said. “We didn’t expect to be supplying vacuums originally, but it really makes a big difference because any vacuum helps, but especially ones that have HEPA filters,’’ which capture more dust particles.