Cost benefits of a peer-led asthma self-management program for adolescents

Abstract

Objective: Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program.

Methods: Randomly assigned adolescents (13-17 years) participated in either peer-led (n = 59) or adult-led (n = 53) asthma self-management program. Health-care utilization data were collected at baseline and at 3-, 6-, and 9-months post-intervention. Negative binomial regression models were conducted to examine the effects of the peer-led program on health-care utilization. Net cost savings were estimated based on the differences in program costs and health-care utilization costs between groups.

Results: Significant group differences were found in acute office visits and school clinic visits after controlling for race and socioeconomic status. The incidence rate of acute office visits was 80-82% less for the peer-led group during follow-ups. The peer-led group was four to five times more likely to use school clinics due to asthma than the adult-led group during follow-ups. The non-research cost of peer-led program per participant was lower than the adult-led program, $64 versus $99, respectively. The net cost saving from the reduction in acute office visits and the lower program costs of the peer-led program was estimated $51.8 per person for a 3-month period.

Conclusions: An asthma self-management program using peer leaders can potentially yield health-care cost savings through the reduction in acute office visits in comparison to a traditional program led by health-care professionals.

Trial registration: ClinicalTrials.gov NCT01161225.