Home visits for asthma patients cut hospitalizations

House calls for low-income families with asthma helped save Children's Hospital Boston $1.46 for every dollar it invested into its home visits program, according to a study in the March issue of Pediatrics (published online yesterday). Using home visits to educate patients and to look for asthma risks, the pediatrics hospital saw a 68 percent decrease from baseline in asthma-related emergency department visits and an 85 percent drop in hospitalizations, according to a hospital announcement yesterday.  

Developed in 2005, Community Asthma Initiative is a community-based asthma care model program that provides families with one or two home visits during the year-long program. The quality improvement intervention focuses on nurse case management and care coordination, combined with home visits by a bilingual nurse or community health worker, to educate families about asthma, assess the home for asthma triggers and provide materials and services to improve the home environment, such as encasements for bedding, HEPA vacuums and pest control. 

Spending the time to work with families outside of the hospital setting seemed to pay off in patient, as well as financial, outcomes. The amount of children who had to limit physicial activity because of their asthma dropped by 43 percent, missed school days decreased by 41 percent and parents who had to miss work to care for their child dropped by half (50 percent).

Children's Hospital Boston also said that the program yielded returns on investments. The program cost $2,529 per child, but it yielded a savings of $3,827 per child because of reduced ED visits and hospitalizations.

"This is a remarkable savings to society and reflects better health outcomes for the children," Elizabeth Woods of the division of adolescent/young adult medicine said.

The home-visits strategy isn't only en vogue for asthma patients. A study last month also found that a prevention program called HouseCalls helped diabetic patients stay out of the hospital. Medicare beneficiaries in the program saw a 19 percent reduction in risk-adjusted hospital days per enrollee than fee-for-service enrollees.

Although house visit programs might seem like they take heavy up-front investments to implement, both studies stipulate that the returns can be worth it in reduced hospitalizations that offset the initial costs.

For more information:
- read the press release
- check out the study abstract

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