Economic Impact of an Asthma Education Programme on Medical Care Utilisation

Abstract

Objective: To determine the economic impact of an asthma education programme. Design and setting: The study was population-based and used claims data to determine changes in the resources used by identified patients with asthma 9 months before (January 1997 to September 1997) and 9 months after (January 1998 to September 1998) the implementation of the asthma education programme. Direct medical costs and frequency of use of services for asthma treatment before and after implementation of the asthma intervention programme were compared to evaluate the impact of the programme on medical treatment costs. Perspective: Third-party payer. Patients: Patients who were diagnosed with asthma at least 12 months prior to the implementation of the intervention were included; all patients were members of a union health and welfare fund, located in the northeastern part of the US. Of the 5527 patients, 2235 were included in the intervention group and 3292 patients served as the control group. Intervention: The asthma education focused on asthma prevention and treatment, recognition and elimination of asthma triggers, and compliance with asthma medications. The programme also included therapy management intervention with physicians, drug product selection and compliance intervention when needed. Main outcome measures and results: The total asthma treatment cost decreased from $US499 to $US415 per patient (a 17% reduction; p = 0.0142) in the intervention group and decreased from $US227 to $US217 in the control group (a 4% decrease; p = 0.6172) [1997 values]. The decrease in the intervention group was significantly greater than that in the control group after controlling for the differences in treatment costs before the intervention (p = 0.0001). The average cost per patient associated with hospitalisation, emergency room visits, physician visits and asthma medications decreased by 13%, 29%, 36% and 18%, respectively, after the intervention in the study group. There was a 9% reduction in the frequency of hospitalisations, a 27% reduction in emergency room usage, a 27% reduction in physician office visits and a 6% reduction in the number of prescriptions per patient for asthma medications after the intervention in the study group. Conclusions: Significant reductions in overall asthma treatment costs were observed after the implementation of the asthma education programme. Therefore, intense patient education and management should be advocated to reduce treatment costs in patients with asthma.