Efficacy, cost effectiveness, and sustainability of a pediatric high risk asthma clinic

Abstract

Aim: At our institution, a pediatric High Risk Asthma clinic has been in operation for over 15 years, targeting children with poorly controlled, and difficult to treat asthma. This study evaluates the outcomes and cost-effectiveness of the High Risk Asthma clinic from 2000 through 2014.

Methods: A retrospective chart review was performed on all patients entering High Risk Asthma clinic from 2000-2014, and total hospitalizations and Emergency Department visits were tallied for the year prior to entering clinic and the year after. Costs incurred, and reimbursements obtained from payors were tallied to determine cost-effectiveness and sustainability.

Results: Consistent decreases in hospitalizations (51.2% decrease, P < 0.001) and Emergency Department visits (23.0% decrease, P = 0.048) were seen for patients entering High Risk Asthma clinic, with commensurate significant decreases in related costs. Reimbursements received for outpatient services were sufficient to offset operational costs of the High Risk Asthma clinic, when both clinic visit, and pulmonary function testing charges were included.

Conclusions: A pediatric High Risk Asthma clinic model is efficacious in decreasing hospitalizations and Emergency Department visits for a difficult to treat population, and such a model can be cost-effective and sustainable.

Keywords: cost-effectiveness; difficult to treat asthma; pediatrics.