Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111773

Helen A. Halpin, PhD and Sara B. McMenamin, PhD, MPH. Center for Health and Public Policy Studies, University of California, Berkeley, 140 Warren Hall, #7360, Berkeley, CA 94720-7360, 510-643-1675, helenhs@berkeley.edu

In February 2004, the California State Assembly introduced Assembly Bill 2185 (AB 2185) that would require health service plans in California to cover self-management training and education for treating pediatric asthma, including the coverage of three medical devices (peak flow meters, nebulizers and spacers). This paper describes the findings of the California Health Benefit Review Program (CHBRP) in reviewing the published evidence on the medical effectiveness of pediatric self-management training and education and the estimated impact that AB 2185 would have on total health care expenditures, monthly premiums, health services utilization and the public's health. A literature review of published trials was conducted using MEDLINE and Cochrane databases from 1980-2003. The findings from the literature search were classified according to various outcomes including: health effects, effects on knowledge and self-efficacy, disability effects, health services utilization effects, and quality of life effects. To evaluate the evidence for each outcome, the authors applied a six point grading system to summarize the patterns of findings from the literature. While there was inadequate evidence to assess the effectiveness of the three medical devises, the evidence suggests that pediatric asthma self-management training and education has favorable effects on a variety of public health outcomes for children with symptomatic asthma, as well as reduces asthma-related emergency room visits and hospitalizations. Using baseline data on utilization, cost, and coverage in California, weighted means of the observed effects were estimated and used to estimate impacts on total health care expenditures, per member per month premiums, as well as impacts on the public's health. The enactment of AB 2185 is estimated to increase premiums on average by $170,000 or $0.013 per member per month. Additionally, the estimated public health impacts include an estimated decrease in 110 asthma-related hospitalizations, 350 fewer asthma-related emergency department visits, 6,000 fewer children with asthma experiencing restricted activity days, and 158,000 fewer days missed from school.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

(
• discuss the medical effectiveness evidence on pediatric asthma self-management training and education, (
• describe the process the California Health Benefit Review Program used to evaluate AB 2185, and (
• develop a similar plan to assess the medical effectiveness and estimate the impact of a health insurance mandate on health insurance costs and the public’s health.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation