breathing easier at home.
by Lynn Thomasson
According to the National Center for Environmental Health, Americans spend an estimated $3.2 billion a year treating children with asthma. Trips to the emergency room, unscheduled doctor’s appointments, prescription inhalers—the cost of treatment can quickly add up. Not to mention missing work or a day of school.
The Inner-City Asthma Study, published last year, found that if parents and caregivers managed environmental factors at home, children could look forward to more symptom-free days and less medication. Now, a new study shows that even though the approach may cost more, the researchers believe the benefits are worth it.
The new study analyzed data from the Inner-City Asthma Study and is published in the Journal of Allergy and Clinical Immunology. The Inner-City Asthma Study followed children between the ages of six and eleven who had moderate to severe asthma and lived in inner cities across the United States.
With the help of environmental counselors, families limited exposure to key asthma triggers such as dust mites, pets, rodents, and mold. Researchers provided each child with an allergen-resistant mattress and pillow cover. The child’s family received a HEPA air cleaner, a HEPA vacuum cleaner, and household pest control. The total cost per family, including pay for the environmental counselors, was over $1,400. Researchers compared the inhalers and medical services used by children in the improved home environments to a control group where home conditions remained the same.
Sally Stearns, an associate professor in health policy and administration at Carolina and a researcher on the study, admits that these changes are not inexpensive. “It’s a sizable chunk of change, but a couple E.R. visits can add up too,” she says.
Researchers estimated that, during the two-year study period, families who changed their home environments would pay about one thousand dollars more than families who did not receive equipment or environmental counseling. The researchers also estimated that the treatment led to thirty-eight more symptom-free days, lower use of the b-agonist inhalers used to control asthma, and fewer unscheduled doctor’s appointments. This means that over two years, each extra symptom-free day cost $27.57.
While the home-based treatment didn’t cut medical costs sufficiently to offset all the added costs, Stearns says the treatment is probably worth it. “Twenty-five dollars a day isn’t cheap, but neither is having the kids out of school,” Stearns says. “We have a hard time putting a monetary value on lost school attendance and parent productivity because of childhood asthma, but the cost may likely exceed $27.57 per day.”
Stearns and her colleagues estimate that the cost could be reduced from $1,400 to just over one thousand dollars if each family used only one environmental counselor. The study sent two environmental counselors to each family making environmental changes, though Stearns says one counselor would be sufficient. This reduced cost could mean that the money saved from less medical treatment could exceed home-based treatment costs within two years. Costs could be further offset if a child had siblings or parents who would benefit from the improved environment.
Sally Stearns is the second author of “Cost Effectiveness of a Home-Based Environmental Intervention for Inner City Children with Asthma.” Meyer Kattan was the study’s lead author. Ellen Crain, James Stout, Peter Gergen, Richard Evans III, Cynthia M. Visness, Rebecca S. Gruchalla, Wayne J. Morgan, George T. O’Connor, J. Patrick Mastin, and Herman Mitchell also contributed to the study. Support came from the National Institute of Allergy and Infectious Diseases and the National Institute of Environmental Health Sciences.