The Economics of an Intensive Education Programme for Asthmatic Patients

Abstract

The costs and benefits of a planned patient education programme for patients with asthma were evaluated in a controlled trial. The patient education group received a planned patient education programme, performed by a physician, a pharmacist and a nurse over a 6-month period. Changes in the use of resources, productive output and in health status were measured for the patient education group and the control group. The total cost for planning, implementation and evaluation of the programme was 14074 British pounds sterling. The patient education group increased its contacts to general practitioners and the extra costs totalled 252 British pounds sterling. The increased costs of drugs used by the patient education group in the 6-month period was 2313 British pounds sterling compared with costs in the control group. The number of days lost through sickness decreased in the patient education group, corresponding to a 4528 British pounds sterling saving of otherwise lost earnings. The quality of life increased in the patient education group by 3.2 points on the Psychosomatic Discomfort Scale (2.9%). Health status increased by 38.9%. The study shows that the patient education programme has a positive clinical effect on the patient's quality of life and health status. The economic consequences of the implementation programme depend on the specific setup of the local healthcare system, where the programme is applied.

Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs

“…Additional long term studies are needed to confirm the findings of this cost analysis of nurseled outpatient management in patients with more severe asthma. Previous studies have evaluated the effect of educational intervention by asthma nurses on the costs of management of asthma both in children and adults [10,12,[22][23][24][25]. The economical consequences of these interventions were inconclusive.…”

“…The economical consequences of these interventions were inconclusive. Some of these studies reported a cost reduction [10,12,22,23], whilst others found that extra investments were needed to achieve a reduction in healthcare utilisation of the patients [24,25]. In these studies, however, the asthma nurse intervention was additional to the routine medical care.…”

“…Furthermore, maintenance treatment with inhaled corticosteroids has been shown to be cost effective [19][20][21]. The consequences of intervention by asthma nurses on healthcare costs are, however, inconclusive [10,12,[22][23][24][25]. This may be due to the fact that until now, care provided by an asthma nurse has always been additional to routine medical care.…”

The costs of asthma

“…However, the improved control reduces other costs [27,28]. For example, controlled asthmatic patients were estimated to require fewer visits to physicians, fewer hospitalizations, and fewer days off work than uncontrolled asthmatic patients, regardless of disease severity.…”

“…Education programmes reduce the number of days taken off work by patients with moderate-to-severe asthma [40], and the number of schooldays missed by asthmatic children [38]. SØNDERGAARD et al [28] showed that a patient education programme resulted in increased GP visits over a 6 month period. These costs were offset by a reduction in days lost from work and an improvement in the patients' quality of life.…”