Background
Caregivers who smoke and have children with asthma are an important group for intervention. Home‐based interventions successfully reduce asthma morbidity, yet are costly. This study evaluated the financial return on investment (ROI) of the Parents of Asthmatics Quit Smoking (PAQS) program, a combined asthma education and smoking cessation intervention.
Methods
Participants included caregivers (n = 224) that smoked, had a child with asthma, and were enrolled in a Medicaid managed care plan. Participants received nurse‐delivered asthma education and smoking counseling in three home visits. Program implementation costs were estimated, and healthcare expenses were obtained from insurance claims data 12 months pre‐ and 12 months post intervention. ROI was calculated for all participants, children <6 years, children 6–18 years, and children with moderate/severe persistent asthma.
Results
Total program implementation cost was $34,481. After intervention, there was increased mean annual refills of beta‐agonist (0.51 pre, 1.64 post; P < 0.001), and controller medications (0.65 pre, 2.44 post; P < 0.001). Reductions were found in mean annual emergency department visits (0.33 pre, 0.14 post; P < 0.001), hospitalizations (0.23 pre, 0.08 post; P < 0.001), and outpatient visits (2.33 pre, 1.45 post, P < 0.001). The program had negative ROI (−21.8%) for the entire sample. The ROI was positive (+106.9) for children <6 years, negative (−150.3) for children 6–18, and negligible for moderate/severe persistent asthma (+6.9%).
Conclusion
PAQS was associated with increased medication use and decreased healthcare utilization. While the overall ROI for PAQS was negative, PAQS had a positive ROI for caregivers of young children with asthma. Pediatr Pulmonol. 2012. 47:950–955. © 2012 Wiley Periodicals, Inc.