Effect of Educational Programs for Asthma in Ambulatory Settings on Pediatric Emergency Room Visits and Hospitalization Rates and Cost

Abstract

Asthma is the leading cause of chronic illness in childhood in the developed world and it accounts for a major part of health care expenditures. Despite modern modes of therapy, the morbidity and mortality rates for asthma have increased over the last two decades. This study evaluated the effect of a self-management education program in an ambulatory asthma clinic of a major medical center on the rate of pediatric emergency department visits, hospitalizations, and cost. We found that both emergency department visits and hospitalization rates decreased significantly from 2 years before establishment of the clinic to 2 years after, from 8.34% to 5.77% and from 7.70% to 5.88%, respectively. A dramatic increase was seen in the number of hospitalized children given preventive therapy (from 11.76% to 65.0%), which probably reflects an increased awareness and better compliance induced by the program. A reduction of 40% in inpatient costs for asthma was achieved, mostly because of fewer hospitalizations. We suggest that family-centered educational programs for pediatric asthma in ambulatory clinics may decrease the need for emergency room visits and hospitalizations and reduce health care costs caused by asthma.