The Breathmobile program: a good investment for underserved children with asthma
The Breathmobile program: a good investment for underserved children with asthma
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DOI：
10.1016/j.anai.2010.07.012
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发表时间：
2010-10-01
影响因子：
5.9
通讯作者：
Mullins, C. Daniel
中科院分区：
文献类型：
--
作者：
Bollinger, Mary Elizabeth;Morphew, Tricia;Mullins, C. Daniel
背景：呼吸移动的，一个基于专业的移动的哮喘诊所，为服务不足的儿童提供免费护理。在这一人群中的无菌日（SFD）的改善成本没有以前reported.Objective：研究的临床影响和成本效益的巴尔的摩Breathmobil.Methods：现有的计算机化数据进行了分析Breathmobile患者访问2002年和2007年之间。计算所有SFD，并将急诊科就诊和住院减少（与前一年相比，计划利用后）导致的直接医疗成本节省与年度运营成本进行比较。增量成本效益比通过计算每增加SFD获得每个孩子每年Breathmobile护理的增量成本确定。结果：该分析包括255例患者参加该计划至少1年。大多数参与者是黑人（93.3%），54.9%是男性。基线时，患者在入组前一年报告的平均（SD）SFD为199（118）。在该项目中1年后，患者的平均（SD）改善为44（9）SFD。该计划导致每获得一个SFD的总成本节省79.43美元，5至11岁儿童的成本节省更多（每增加一次SFD-116.84美元）和间歇性哮喘患者（每增加一个SFD-126.71美元）。巴尔的摩呼吸车项目已经证明了SFD的显著改善，该计划节省的直接医疗费用超过了运营成本。这些数据支持需要继续维持和扩大针对哮喘急性发作高危儿童的Breathmobile项目，并进行随机临床试验以评估Breathmobile的成本效益。安过敏性哮喘免疫学2010;105：274-281。
Background: The Breathmobile, a specialty-based mobile asthma clinic, provides free care to underserved children. The cost of symptom-free day (SFD) improvement in this population has not been previously reported.Objective: To examine the clinical impact and cost-effectiveness of the Baltimore Breathmobile.Methods: Existing computerized data were analyzed for Breathmobile patient visits between 2002 and 2007. All SFDs were calculated, and direct medical cost savings attributable to decreased emergency department visits and hospitalizations (after program utilization vs the previous year) were compared with annual operating costs. Incremental cost-effectiveness ratios were determined by calculating the incremental costs of Breathmobile care per additional SFD gained per child per year.Results: The analysis included 255 patients enrolled in the program for at least 1 year. Most participants were black (93.3%), and 54.9% were male. At baseline, patients reported a mean (SD) of 199 (118) SFDs in the year before enrollment. After 1 year in the program, patients had a mean (SD) improvement of 44 (9) SFDs. The program resulted in overall cost savings of $79.43 per SFD gained, with greater cost savings for children aged 5 to 11 years (-$116.84 per SFD gained) and those with intermittent asthma (-$126.71 per SFD gained).Conclusions: The Baltimore Breathmobile program has demonstrated significant improvement in SFDs, with direct medical cost savings of the program outweighing the operational costs. These data support the need to continue to sustain and expand Breathmobile programs for children at high risk for asthma exacerbations and to conduct a randomized clinical trial to estimate the cost-effectiveness of the Breathmobile. Ann Allergy Asthma Immunol. 2010;105:274-281.