249875 Addressing health disparities in asthma need not be expensive: A cost-effective solution in the face of costly health care

Sunday, October 30, 2011

Pat McLaine, RN, MPH, DrPH , Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD
Carla Intal, MA , Department of Applied Economics, Johns Hopkins University, Washington, DC
Madeleine Shea, PhD , Director of the Office of Population Health Improvement, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Kate Scott, RN, MPH , Healthy Homes and Communities Division, Baltimore City Health Department, Baltimore, MD
The exponential rise in health care costs in the United States over the last 25 years amplifies the widening disparities in health outcomes. Asthma is a chronic disease that illustrates this health gap. In the United States, low-income people and people of color are disproportionately affected by asthma, experiencing higher asthma prevalence and severity relative to wealthier and white populations (Krieger et.al, 2002). More importantly, asthma greatly affects children. It is the most common chronic disease in childhood and the leading non-injury cause of hospitalization among children ages 0-15 (Krieger et.al, 2002).

The Baltimore City Health Department's Reducing Asthma Disparities (RAD) program has provided a home-visiting intervention to families of school children with moderate-severe asthma. This healthy homes approach, focused on helping the parent to reduce exposure to environmental triggers and improving the child's medication compliance, may be a cost-effective approach to reducing asthma disparities among children in Baltimore. We are in the process of estimating the health costs of asthma for Medicaid enrolled children, and we will match them against the costs averted by the RAD program. We will utilize logistic regression techniques to analyze parent-reported outcomes and Medicaid costs, and we will compare our methods with traditional approaches. We will also discuss the strengths and limitations of our cost-effectiveness approach to showcase how economic evaluation is an essential part of assessing the impact and the sustainability of public health programs.

Learning Areas:
Biostatistics, economics
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Environmental health sciences
Implementation of health education strategies, interventions and programs
Public health or related public policy

Learning Objectives:
Compare the economic costs of asthma for Medicaid-enrolled children in Baltimore City with the costs averted by the Baltimore City Health Department's Reducing Asthma Disparities Program.

Keywords: Asthma, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the evaluator for this translational research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.