An economic evaluation of short-term inpatient rehabilitation for children with severe asthma

Background: The cost of asthma care in the United States in 1990 has been estimated to be 6.2 billion dollars. the greatest proportion is due to hospital care. Objective: We report changes in estimated medical charges of 59 children with severe asthma 1 year before inpatient rehabilitation and over a 4-year follow-up period. Methods: Asthma resource use (e.g., hospital, physician, medication) was identified before and after inpatient rehabilitation. Estimated charges were assigned. this was done retrospectively for the 1-year period before rehabilitation, prospectively during rehabilitation, and over a 4-year followup period. Patients served as their own controls. there was no control group. Results: When median asthma resource use 1 year before rehabilitation was compared with that during the first, second, third, and fourth years of follow-up, there was a reduction in median hospitalization and median emergency care. compared with mean total medical charges the year before rehabilitation, reductions in mean total medical charges were 56.7% at the completion of the first year (excluding charges for rehabilitation), 70.5% at second year, 74.6% at third year, and 77.5% at fourth year. Over the 4-year postrehabilitation period, the discounted cumulative net savings was $29,605. the discounted cumulative net savings surpassed the mean rehabilitation charge during the early months of the fourth year of the postrehabilitation period. Conclusion: Inpatient rehabilitation was significantly associated with a reduction in estimated total medical charges over a 4-year follow-up period.