TY - JOUR
T1 - Estimating the impact of self-management education, influenza vaccines, nebulizers, and spacers on health utilization and expenditures for Medicaid-enrolled children with asthma
AU - Yildirim, Melike
AU - Griffin, Paul
AU - Keskinocak, Pinar
AU - O’Connor, Jean C.
AU - Swann, Julie L.
N1 - Funding Information:
P. Griffin was supported by Regenstreif Center. P. Keskinocak received partial support from William W. George chair. J. Swann received partial support from A. Doug Allison chair.
Funding Information:
Medicaid claims data were available at Georgia Tech through support by the Institute for People and Technology, Stewart School of Industrial and Systems Engineering, and Children’s Healthcare of Atlanta.
Publisher Copyright:
© 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2021
Y1 - 2021
N2 - Introduction: We quantify the effect of a set of interventions including asthma self-management education, influenza vaccination, spacers, and nebulizers on healthcare utilization and expenditures for Medicaid-enrolled children with asthma in New York and Michigan. Methods: We obtained patients’ data from Medicaid Analytic eXtract files and evaluated patients with persistent asthma in 2010 and 2011. We used difference-in-difference regression to quantify the effect of the intervention on the probability of asthma-related healthcare utilization, asthma medication, and utilization costs. We estimated the average change in outcome measures from pre-intervention/intervention (2010) to post-intervention (2011) periods for the intervention group by comparing this with the average change in the control group over the same time horizon. Results: All of the interventions reduced both utilization and asthma medication costs. Asthma self-management education, nebulizer, and spacer interventions reduced the probability of emergency department (20.8–1.5%, 95%CI 19.7–21.9% vs. 0.5–2.5%, respectively) and inpatient (3.5–0.8%, 95%CI 2.1–4.9% vs. 0.4–1.2%, respectively) utilizations. Influenza vaccine decreased the probability of primary care physician (6–3.5%, 95%CI 4.4–7.6% vs. 1.5–5.5%, respectively) visit. The reductions varied by state and intervention. Conclusions: Promoting asthma self-management education, influenza vaccinations, nebulizers, and spacers can decrease the frequency of healthcare utilization and asthma-related expenditures while improving medication adherence.
AB - Introduction: We quantify the effect of a set of interventions including asthma self-management education, influenza vaccination, spacers, and nebulizers on healthcare utilization and expenditures for Medicaid-enrolled children with asthma in New York and Michigan. Methods: We obtained patients’ data from Medicaid Analytic eXtract files and evaluated patients with persistent asthma in 2010 and 2011. We used difference-in-difference regression to quantify the effect of the intervention on the probability of asthma-related healthcare utilization, asthma medication, and utilization costs. We estimated the average change in outcome measures from pre-intervention/intervention (2010) to post-intervention (2011) periods for the intervention group by comparing this with the average change in the control group over the same time horizon. Results: All of the interventions reduced both utilization and asthma medication costs. Asthma self-management education, nebulizer, and spacer interventions reduced the probability of emergency department (20.8–1.5%, 95%CI 19.7–21.9% vs. 0.5–2.5%, respectively) and inpatient (3.5–0.8%, 95%CI 2.1–4.9% vs. 0.4–1.2%, respectively) utilizations. Influenza vaccine decreased the probability of primary care physician (6–3.5%, 95%CI 4.4–7.6% vs. 1.5–5.5%, respectively) visit. The reductions varied by state and intervention. Conclusions: Promoting asthma self-management education, influenza vaccinations, nebulizers, and spacers can decrease the frequency of healthcare utilization and asthma-related expenditures while improving medication adherence.
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U2 - 10.1080/02770903.2020.1821056
DO - 10.1080/02770903.2020.1821056
M3 - Article
C2 - 33031709
AN - SCOPUS:85092515760
SN - 0277-0903
VL - 58
SP - 1637
EP - 1647
JO - Journal of Asthma
JF - Journal of Asthma
IS - 12
ER -