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Your Environment. Your Health.

A cost-benefit analysis of a state-funded healthy homes program for residents with asthma: findings from the New York state healthy neighborhoods program

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost-benefit analysis (CBA)
Gomez M, Reddy AL, Dixon SL, Wilson J, Jacobs DE
Journal of Publich Health Management and Practice
This cost-benefit analysis study examined the costs and savings associated with a home-based asthma intervention implemented through the NYS HNP. The authors determined for people in the study with poorly controlled asthma, cost savings for all medical encounters and medications were $1,083 per in-home visit, with a net benefit of $781 per visit. For people in the study with active asthma, the cost savings were $613 and the net benefit was $311 per in-home visit. The authors concluded that low-intensity, home-based environmental interventions decreased costs of health care utilization for people with asthma. The authors encourage health care payers to consider expanding coverage to include these services particularly for patients with poorly controlled asthma.
Children and adults (≥5 years)

Health Outcomes

  • Respiratory outcomes (asthma)

Environmental Agents

List of Environmental Agents: (Not available)

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source


  • Cost-benefit analysis (CBA)

Cost Measured:

  • Costs of standard home visits, additional costs of asthma visits, administrative costs of a home visit, travel costs, and costs of standard and asthma-specific products distributed during home visits
  • New York state Medicaid costs per person for outpatient visits, emergency department visits, hospital stays, and medications

Potential Cost Measures:

  • Variations in costs based on geographic variation in housing conditions, improvements, and operating costs

Benefits Measures:

  • Costs saved by reductions in medical encounters and medications

Potential Benefits:

  • Additional benefits that could be measured through longer-term follow-up


  • 13 rural and urban counties in New York State

Models Used: (Not available)

Methods Used:

  • The authors calculated costs and savings of a home-based asthma intervention program in rural and urban New York from a health care payer perspective. The authors — 1) gathered data from the New York State (NYS) Health Neighborhoods Program (HNP) that included home visits and at least one follow up visit within 3-12 months for people enrolled in the program; 2) conducted a cost study in four counties over two 2-week periods to gather data from HNP administrators and workers on costs related to a home visit for asthma; 3) collected health data from a standardized asthma assessment form used during HNP home visits with details about health care service usage and prescriptions during the previous week; 4) calculated the change since the first home visit as the proportion of health data changes from the first visit to the follow up visit; 5) collected data for total cost in 2010 for asthma-related services and medications for Medicaid enrollees in NYS; 6) calculated the mean change in the medical encounter or medication use multiplied by the average cost of the encounter or medication; and 7) calculated the benefit to cost ratio as the change in health care utilization divided by the cost of an HNP asthma home visit.

Sources Used:

  • Home visits cost and self-reported health data collected over two 2-week periods in four counties performing HNP home visits for asthma by HNP staff; total costs in 2010 for asthma-related services and medication for NYS Medicaid enrollees obtained from the NYS Office of Health Insurance Programs; additional sources cited in the publication

Economic Evaluation / Methods and Source


  • Gomez M, Reddy AL, Dixon SL, Wilson J, Jacobs DE. 2017. A cost-benefit analysis of a state-funded healthy homes program for residents with asthma: findings from the New York state healthy neighborhoods program. Journal of Publich Health Management and Practice.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding: (Not available)

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