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A study commissioned by the Asthma Regional Council of New England (ARC), and supported by Children's Hospital Boston, finds that there is a compelling health and economic case for investing in prevention-oriented programs that emphasize patient education and in-home controls of environmental triggers of asthma. The study was conducted by the University of Massachusetts Lowell's (UML) Environmental Health Initiative.
The study -- Investing in Best Practices for Asthma -- found that effective patient asthma education led to fewer emergency room visits, fewer hospitalizations, improvement in the quality of life and lung function of patients, and fewer lost school and work days. It also showed that many of these outcomes can translate directly into substantial costs savings, especially when targeted to high risk asthma patients.
"This study indicates that current approaches to managing asthma--which rely primarily on encouraging compliance with medications--are not working for a lot of people," says Laurie Stillman, director of ARC. "It shows we can improve asthma outcomes in a cost effective manner if high risk patients are provided with additional education and environmental improvements in the home."
The study calls for health insurers to pay for asthma care that extends beyond physician office visits, which they typically don't cover. It also includes three case studies of health plans that currently cover asthma education and environmental interventions, delivered by professionals who are not physicians. These programs decreased asthma-related hospitalizations and emergency room visits, and realized significant net cost savings. In New England, some local Medicaid Managed Care plans are already beginning to invest in similar programs.
"We found cost savings ranging from more than $7 for every $1 invested in asthma education to as high as $36 for every $1 invested," says UML researcher Polly Hoppin, PhD. "Our review of the published literature concludes that we can reduce health care costs by providing patients and families with asthma education programs above and beyond what a clinician typically covers in a sick or well visit. Further, these programs can effectively be provided by professionals other than physicians."
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