Cost Benefits of a Peer-Led Asthma Self-Management Program for Adolescents

Abstract

Objective. Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program. Methods. Randomly assigned adolescents (13–17 years) participated in either peer-led (n = 59) or adult-led (n = 53) asthma self-management program. Health-care utilization data were collected at baseline and at 3-, 6-, and 9-months post-intervention. Negative binomial regression models were conducted to examine the effects of the peer-led program on health-care utilization. Net cost savings were estimated based on the differences in program costs and health-care utilization costs between groups. Results. Significant group differences were found in acute office visits and school clinic visits after controlling for race and socioeconomic status. The incidence rate of acute office visits was 80–82% less for the peer-led group during follow-ups. The peer-led group was four to five times more likely to use school clinics due to asthma than the adult-led group during follow-ups. The nonresearch cost of peer-led program per participant was lower than the adult-led program, $64 versus $99, respectively. The net cost saving from the reduction in acute office visits and the lower program costs of the peer-led program was estimated $51.8 per person for a 3-month period. Conclusions. An asthma self-management program using peer leaders can potentially yield health-care cost savings through the reduction in acute office visits in comparison to a traditional program led by health-care professionals.

• adolescents
• camp
• cost savings
• health-care utilization
• peer leaders

Acknowledgments

The authors thank Dr. Michael Belyea for his statistical consultation. The authors are also gratefully acknowledge the assistance that Judy Brasch and other research staff had provided during the project period.

Declaration of Interest

This study was supported by a grant from the NIH/NINR (R21 NR009837) awarded to Dr. Hyekyun Rhee. This study protocol has been registered with ClinicalTrials.gov (Identifier: NCT01161225). All authors do not have any financial and personal relationships with other people or organizations that could influence (bias) this work. We have no discloses of any affiliation with any organization with a financial interest, direct or indirect, in the subject matter or materials discussed in the article (such as consultancies, employment, paid expert testimony, honoraria, speakers bureaus, retainers, stock options or ownership, patents or patent applications, or travel grants) that may affect the conduct or reporting of the work submitted. The authors are solely responsible for the content of the article.