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Cost-effectiveness of a home-based environmental intervention for inner-city children with asthma

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost-benefit analysis (CBA), Cost-effectiveness analysis (CEA)
Authors
Kattan M, Stearns SC, Crain EF, Stout JW, Gergen PJ, Evans R 3rd, Visness CM, Gruchalla RS, Morgan WJ, O'Connor GT, Mastin JP, and Mitchell HE
Journal
Journal of Allergy and Clinical Immunology
Summary
The authors of this study calculated the benefits of a home-based environmental remediation for young, asthmatic children. They determined that the intervention, which cost $1,469 per family, led to a statistically significant reduction in asthma-symptom days, unscheduled clinic visits, and use of beta-agonist inhalers. Findings indicated that the intervention is cost-effective when the aim is to reduce asthma symptom days and the associated costs.
Population
Children (6-11 years) enrolled in the Inner City Asthma Study (ICAS) with moderate-to-severe asthma

Health Outcomes

  • Respiratory outcomes (asthma)

Environmental Agents

List of Environmental Agents:

  • Air pollutants (tobacco smoke)
  • indoor allergens (dust mite, cockroach, mold, pets, rodents)

Source of Environmental Agents:

  • Allergens from pests (cockroaches, rodents)
  • cigarette smoke (secondhand smoke)

Economic Evaluation / Methods and Source

Type:

  • Cost-benefit analysis (CBA)
  • Cost-effectiveness analysis (CEA)

Cost Measured:

  • Healthcare use costs (scheduled/unscheduled medical visits, emergency department visits, inpatient hospital days, medications/pharmaceutical use)
  • costs of the intervention which included skin tests, anti-allergen equipment (e.g., impermeable mattress and pillow covers, HEPA vacuum cleaner, HEPA air cleaner, vent filters)
  • salary for environmental counselor
  • travel costs
  • pest management services

Potential Cost Measures:

  • School days lost
  • days on which caretaker had to change plans due to child's asthma

Benefits Measures:

  • Number of asthma-symptom free days
  • reduced healthcare costs

Potential Benefits:

  • Reduction in health costs and asthma symptom-free days for other household members

Location:

  • Cities within the United States — Boston
  • New York City
  • Chicago
  • Dallas
  • Seattle
  • Tucson

Models Used: (Not available)

Methods Used:

  • The authors used incremental cost-effectiveness ratios (ICER) to assess the cost-effectiveness of a home-based environmental allergen and irritant remediation intervention among inner-city children aged 6-11 years with moderate-to-severe-asthma over a two-year study period.

Sources Used:

  • Inner-City Asthma Study (ICAS); National Cooperative Inner-City Asthma Study (NCICAS); Medicaid Reimbursement Survey; American Academy of Pediatrics (2001); The cost-effectiveness of an inner-city asthma intervention for children (Sullivan et al., 2002); Kids Inpatient Database (Hospital Cost and Utilization Project, 2000); Drugs for Asthma (The Medical Letter, Vol. 42, 2000); Drug Topics Red Book (2000); Update and First DataBank Price Alert (2000); additional sources cited in publication

Economic Evaluation / Methods and Source

Citation:

  • Kattan M, Stearns SC, Crain EF, Stout JW, Gergen PJ, Evans R 3rd, Visness CM, Gruchalla RS, Morgan WJ, O'Connor GT, Mastin JP, and Mitchell HE. 2005. Cost-effectiveness of a home-based environmental intervention for inner-city children with asthma. Journal of Allergy and Clinical Immunology.

Pubmed:

DOI:

NIEHS Funding: (Not available)

Other Funding: (Not available)